Maggots and Leeches Used For Wound Cleaning and Solving Crimes

Leeches are black or brown and most live in freshwater environments. There are up to 1,000 species of leeches throughout the world. Some leeches feed on decaying plant material and others feed on blood and tissue of other animals.

Even if you know where to look for them, leeches are hard to find since most species are camouflaged and blend in with their environment.

Leeches can have either two or three jaws, which look like half circular saw blades. Leeches with two jaws leave a bite shaped like the letter V. Leeches with three-jaws leave a leave a bite shaped like the letter Y.

If you get a leech on you, use your fingernail or something flat and blunt to break the seal of the sucker at the smaller end of the leech. Then break the seal at the other end. The leech should detach its jaws and you can flick it away.

Some people try other ways to remove leaches like using a cigarette lighter or lit cigarette, a carbonated drink, salt or soap, lemon juice or vinegar, alcohol, or an insect repellent. Using these methods might cause the leech to regurgitate into the wound before it detaches. The vomit could carry disease and possibly cause infection.

If you can't remove a leach, it will normally detach itself in about 20 minutes after it has filled itself with your blood. If a leech is attached internally, such as in a nasal passage or ear, you should seek medical help.

Photo by Mick E. Talbot on flickr.

When microsurgery became possible in the 1980s, one major problem was congestion in the veins because of inefficient drainage. If the congestion doesn't clear up right away, the blood around the wound will clot. The arteries bringing fresh blood to the tissue become plugged and then the tissue dies.

To prevent the tissue from dying, leeches are applied to a congested flap. The leech consumes some of the excess blood and then detaches itself. The wound bleeds for a while longer because of the anticoagulant in the leech's saliva. An anticoagulant keeps blood from going from a liquid to a solid or semisolid state. Keeping the blood a liquid promotes healing by letting fresh, oxygenated blood to reach the area.

Leeches help physicians with treating serious circulation disorders. with reattaching severed fingers, toes, and ears, with scalp reattachment and limb transplants, with breast reconstruction, and to relieve pain in patients with osteoarthritis of the knee.

On June 28, 2004, the Food and Drug Administration (FDA) approved commercial marketing of leeches for medicinal purposes; like for reattachment surgery and skin grafts.

The first medicinal leeches were gathered from streams and rivers, but today there are companies that function as leech farms.

But some patients can't stand the thought of leeches on their skin. And leeches sometimes will slip off the skin and then attach itself to another area. So scientists have developed a "mechanical leech".

"In the case of the leech in medicine, we think we can improve on nature," says Nadine Connor, a University of Wisconsin at Madison scientist who in 2001 helped develop the mechanical leech, which looks like a small bottle attached to a suction cup. It delivers an anti-clotting drug to the wound and then sucks out the amount of blood the doctor determines (real leeches drop off when full).

But many physicians prefer using the natural leech. Leeches cost less and are self-reproducing.

Photo by OakleyOriginals on flickr.

Maggot is the common name for fly larvae; specifically houseflies, cheese flies, and blowflies.

The maggot of the blow fly (or bottle fly) is the most common maggot found in peoples' homes. Fully grown maggots are a creamy white color and about a half inch in length.

Adult blow flies lay eggs on or near rotting vegetables, manure, or dead animals. Eggs hatch quickly, and maggots begin to eat on the decaying matter. Depending on the temperature, maggots become adults within a few days. Six or more generations of fly eggs can hatch in one summer.

Flies spread disease to animals; usually sheep, deer, and cattle. An infection of an animal with fly larvae (maggots) is called myiasis. Humans can also get myiasis, when certain flies are attracted to wounds and then lay eggs. Humans can get intestinal myiasis from eating food containing fly larvae eggs.

Maggots can be useful, though. After other scavengers are done eating the flesh of dead animals, what's left is quickly reduced to bone by maggots, returning nutrients to the soil.

Photo by tothalvadi by flickr.

MRSA (Methicillin-resistant Staphylococcus aureus) is a type of staph bacteria that doesn't respond to traditional antibiotics commonly used to treat staph infections. MRSA is considered a superbug.

ScienceDaily (May 5, 2007) - University of Manchester researchers are ridding diabetic patients of the superbug MRSA - by treating their foot ulcers with maggots. Professor Andrew Boulton and his team used green bottle fly larvae to treat 13 diabetic patients whose foot ulcers were contaminated with MRSA and found all but one were cured within a mean period of three weeks, much quicker than the 28-week duration for the conventional treatment.

Professor Boulton and his team have used maggots to treat diabetic foot ulcers of patients for ten years. More recently they found that many of their patients were suffering from MRSA-contaminated foot ulcers, with the rate doubling in a three year period.

In their first study, they treated 13 patients, aged 18-80 years with chronic foot ulcers who had suffered loss of feeling and reduced blood supply, with sterile free-range green bottle fly larvae. Depending on the size of the ulcer, they applied the larvae between two and eight times for four days at a time, with pressure relieving dressings to protect them. No topical antimicrobial agents or growth factors were used.

All but one of the patients was cleared of the MRSA superbug. During the treatment period, no adverse reactions were reported.

Professor Boulton said: "This is very exciting. We have demonstrated for the first time the potential of larval therapy to eliminate MRSA infection of diabetic foot ulcers. If confirmed in a randomized controlled trial, larval treatment would offer the first non-invasive and risk-free treatment of this increasing problem and a safe and cost-effective treatment in contrast to the expensive and potentially toxic antibiotic remedies."

The information above is from the article:
'Larval Therapy: A Novel Treatment in Eliminating Methicillin-Resistant Staphylococcus aureus From Diabetic Foot Ulcers' is in Diabetes Care, Volume 30, Number 2, February 20. Click here to read the entire article

Photo by stevendepolo on flickr

The following information is from Aetna Insurance's website.

Clinical Policy Bulletin:
Bio-Surgery: Medicinal Leech Therapy and Medical Maggots

1. Aetna considers medicinal leech (Hirudo medicinalis) therapy medically necessary for any of the following conditions:

1. Poor venous drainage (venous congestion/venous outflow obstruction); or

2. Salvage of vascularly compromised flaps (muscle, skin, and fat tissue surgically removed from one part of body to another); or

3. Salvage of vascularly compromised replants (limbs or other body parts re-attached after traumatic amputation).

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2. Aetna considers medicinal leech therapy experimental and investigational for treating cancer pain, knee osteoarthritis, inadequate arterial supply or tissue ischemia, and for all other indications.

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3. Aetna considers medical maggots medically necessary for the debridement of any of the following non-healing necrotic skin and soft tissue wounds:

1. Neuropathic foot ulcers; or 

2. Non-healing traumatic or post surgical-wounds; or

3. Pressure ulcers; or

4. Venous stasis ulcers. 

Read the complete Policy on ON AETNA'S WEBSITE



http://www.flickr.com/photos/blueboat2/5981960956/

A forensic entomologist often assists when a suspicious death occurs, determining the victim's time of death based on insects found on or around the body.

Insects colonize cadavers in a predictable order. Minutes after death, blow flies usually appear and then flesh flies. Dermestid beetles arrive next and then other fly species. Predatory and parasitic insects then come to feed on the beetle and fly larvae. As the corpse dries, clothes moths and hide beetles finish what remains.

Forensic entomologists collect samples of insects at the crime scene. In the lab, each insect is identified and their developmental stage is noted. Some insects live only on certain plants or in specific areas, climates, or elevations. If an insect does not live in the area, the body has probably been moved.

When a suspicious death is investigated, the medical examiner usually tests for drugs or toxins. But body tissue decompose quickly, so getting a tissue sample may not be possible. Certain insects that feed on corpses also consume substances in the tissues, including drugs or poisons. Tests on the insects themselves might show if there were any toxic substances in the body at the time of death.

Photo by echoforsberg on flickr.