Muddle stops medical use of maggots

PATIENTS are being denied a simple, cheap treatment that helps to prevent amputation, because of a bureaucratic bungle.

Packs of sterile maggots, which help patients to heal without long stays in hospital, have been barred from GPs' surgeries even though they have been awarded "Millennium Product" status by Tony Blair.

"Larval therapy" - the use of maggots on wounds - has been used for centuries and modern scientific tests have proved its efficacy.

Yet it is denied to thousands of injured patients and does not feature on the official list of approved medicines; only hospital consultants are allowed to buy the maggots. The Welsh laboratory that produces the packs is campaigning to put them on prescription and wants the Welsh Assembly to help.

The therapy, used widely in the First World War, has been credited in some cases with preventing amputation. The packs - the only supply of sterile maggots in the UK and the first in Europe - are produced by the NHS-run Surgical Materials Testing Laboratory at the Princess of Wales Hospital in Bridgend, Mid-Glamorgan.

Steve Thomas, the lab's director, said that the pounds 50 packs have been sold "by the back door" since they were developed three years ago. Purchasers are mainly consultants who have more freedom than other doctors and nurses to buy treatments not on the approved-drugs tariff.

Because the maggots are a live biological product they fall into a gap between the remits of the Medical Devices Agency and Medicines Control Agency.

Dr Thomas said: "The problem is that the drug tariff is only for pharmaceutical products or medical devices, which includes dressings. The legislation precludes sales of live origin. But the therapy could be much more widely used by community nurses in patients' own homes.

"We have got Millennium Product status. I think Tony Blair ought to know that government departments aren't talking to each other."

Dr Thomas is planning to raise the issue with the Welsh Assembly and Mr Blair at a reception for Millennium Product status holders in the New Year.

Because the maggots turn into flies after a few days, they are not suitable for exhibiting in the Millennium Dome, but will join an exhibition of all Millennium Products later.

Peter Vowden, a vascular surgeon at Bradford Royal Infirmary, has treated more than 300 patients with larval therapy. He says that in some cases it has avoided amputations and lengthy "debridement", where dead or infected tissue is removed.

"There are cases where larval therapy is undoubtedly the best method - heel ulcers close to the bone, for example," he said. "Hospital consultants have a great deal more freedom over the products they use. It doesn't need to be a recognised product on the drug tariff if you know enough about it."

Mr Vowden does not favour the packs being freely available to all clinicians, but to specialist wound-care nurses who are trained in using it. "Nurses have probably the greatest control over wounds and are the most appropriate people to use it. Doctors are not trained in wound care as part of the standard medical education, apart from those with a particular interest. A lot of them are vascular surgeons."

Maggots have been known for centuries to heal wounds, offering protection against gangrene and infection.

During the American Civil War, an army doctor wrote: "Maggots, in a single day, would clean a wound much better than any agents we had at our command. I am sure I saved many lives by their use." In the First World War, soldiers would deliberately put maggots in their wounds.

The advent of antibiotics in the 1940s saw the demise of the maggot as a therapeutic agent. The rise of resistant bacteria led to a resurgence of interest. Today, larval therapy is widely recognised as an efficient, cost-effective way of cleaning infected wounds and removing dead and infected tissue.

PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
News
video
Life and Style
tech
Arts and Entertainment
Southern charm: Nicolas Cage and Tye Sheridan in ‘Joe’
filmReview: Actor delivers astonishing performance in low budget drama
Arts and Entertainment
While many films were released, few managed to match the success of James Bond blockbuster 'Skyfall'
film
Arts and Entertainment
Up my street: The residents of the elegant Moray Place in Edinburgh's Georgian New Town
tvBBC's The Secret History of Our Streets reveals a fascinating window into Britain's past
Extras
indybest
News
Albus Dumbledore, the headmaster of Hogwarts School of Witchcraft and Wizardry has been the teaching profession's favourite teacher
education
Sport
Luis Suarez looks towards the crowd during the 2-1 victory over England
sport
Life and Style
Cheesecake frozen yoghurt by Constance and Mathilde Lorenzi
food + drinkThink outside the cool box for this summer’s frozen treats
News
John Barrowman kisses his male “bride” at a mock Gretna Green during the Commonwealth Games opening ceremony
peopleBarrowman's opening ceremony message to Commonwealth countries where he would be sent to prison for being gay
Sport
Sir Bradley Wiggins removes his silver medal after the podium ceremony for the men’s 4,000m team pursuit in Glasgow yesterday
Commonwealth games Disappointment for Sir Bradley in team pursuit final as England are forced to settle for silver
Sport
Alistair Brownlee (right) celebrates with his gold medal after winning the men’s triathlon alongside brother Jonny (left), who got silver
England's Jodie Stimpson won the women’s triathlon in the morning
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

SQL Report Analyst (SSRS, CA, SQL 2012)

£30000 - £38500 Per Annum + 25 days holiday, pension, subsidised restaurant: C...

Application Support Analyst (SQL, Incident Management, SLAs)

£34000 - £37000 Per Annum + excellent benefits: Clearwater People Solutions Lt...

Embedded Software / Firmware Engineer

£40000 - £45000 per annum + Pension, Holiday, Flexi-time: Progressive Recruitm...

Developer - WinForms, C#

£280 - £320 per day: Progressive Recruitment: C#, WinForms, Desktop Developmen...

Day In a Page

Backhanders, bribery and abuses of power have soared in China as economy surges

Bribery and abuses of power soar in China

The bribery is fuelled by the surge in China's economy but the rules of corruption are subtle and unspoken, finds Evan Osnos, as he learns the dark arts from a master
Commonwealth Games 2014: Highland terriers stole the show at the opening ceremony

Highland terriers steal the show at opening ceremony

Gillian Orr explores why a dog loved by film stars and presidents is finally having its day
German art world rocked as artists use renowned fat sculpture to distil schnapps

Brewing the fat from artwork angers widow of sculptor

Part of Joseph Beuys' 1982 sculpture 'Fettecke' used to distil schnapps
BBC's The Secret History of Our Streets reveals a fascinating window into Britain's past

BBC takes viewers back down memory lane

The Secret History of Our Streets, which returns with three films looking at Scottish streets, is the inverse of Benefits Street - delivering warmth instead of cynicism
Joe, film review: Nicolas Cage delivers an astonishing performance in low budget drama

Nicolas Cage shines in low-budget drama Joe

Cage plays an ex-con in David Gordon Green's independent drama, which has been adapted from a novel by Larry Brown
How to make your own gourmet ice lollies, granitas, slushy cocktails and frozen yoghurt

Make your own ice lollies and frozen yoghurt

Think outside the cool box for this summer's tempting frozen treats
Ford Fiesta is UK's most popular car of all-time, with sales topping 4.1 million since 1976

Fiesta is UK's most popular car of all-time

Sales have topped 4.1 million since 1976. To celebrate this milestone, four Independent writers recall their Fiestas with pride
10 best reed diffusers

Heaven scent: 10 best reed diffusers

Keep your rooms smelling summery and fresh with one of these subtle but distinctive home fragrances that’ll last you months
Commonwealth Games 2014: Female boxers set to compete for first time

Female boxers set to compete at Commonwealth Games for first time

There’s no favourites and with no headguards anything could happen
Five things we’ve learned so far about Manchester United under Louis van Gaal

Five things we’ve learned so far about United under Van Gaal

It’s impossible to avoid the impression that the Dutch manager is playing to the gallery a little
Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

Screwing your way to the top?

Good for Lana Del Rey for helping kill that myth, says Grace Dent
Will the young Britons fighting in Syria be allowed to return home and resume their lives?

Will Britons fighting in Syria be able to resume their lives?

Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
Beyoncé poses as Rosie the Riveter, the wartime poster girl who became a feminist pin-up

Beyoncé poses as Rosie the Riveter

The wartime poster girl became the ultimate American symbol of female empowerment
The quest to find the perfect pair of earphones: Are custom, 3D printed earbuds the solution?

The quest to find the perfect pair of earphones

Earphones don't fit properly, offer mediocre audio quality and can even be painful. So the quest to design the perfect pair is music to Seth Stevenson's ears
US Army's shooting star: Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform

Meet the US Army's shooting star

Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform