May 7, 2016 at 6:50 pm #27043
I can’t remember if we have discussed this (no joy on a search), but this is something we should all be familiar with.
In a world with continuing antibiotic resistant strains and/or a Post-Event world with limited access to antibiotics this maybe the best option at times.
Our friend the maggot may mean the difference between life and death.
As an 80’s military instructor of mine said, you can roast or fry them after they have done their job as they are a great source of protein.
In today’s world it would be a very “Earth Friendly” thing to do, the ultimate in recycling.
Attachments:You must be logged in to view attached files.May 7, 2016 at 7:07 pm #27045
Medical grade maggots are the way to go if available, however as we were taught, just allowing flies access to the wound will get the desired result. A light gauze dressing for a covering once established will keep them from falling out of wound. The maggots will only eat the dead host tissue of the infection. Cleaning and debriding the wound.
The scientific literature identifies three primary actions of medical grade maggots on wounds:
They debride (clean) the wound by dissolving dead and infected tissue with their proteolytic, digestive enzymes;
They disinfect the wound (kill bacteria) by secreting antimicrobial molecules, by ingesting and killing microbes within their gut, and by dissolving biofilm;
They stimulate the growth of healthy tissue.
In North America this should work well, but in several other areas of the world certain species will eat live tissue. I don’t recall which areas off the top of my head, but will see if I can find out that information.
This is the prefered fly you want to use!
Phaenicia (=Lucilia) sericata, the green blow fly.
Note: Remember this is for extreme emergency use (Post-Event or isolated survival situation) where life of person is in jeopardy, but don’t wait too long.May 7, 2016 at 7:43 pm #27046AnonymousInactive
I often wondered what the mental effects of this would be on a person- as in I wondered how irritating it would if one could feel them wriggling about as they feast on the infect wound. Id imagine for most they would not be able to handle even the thought of it. Much like dealing with starvation they would rather die.
BergmannMay 7, 2016 at 9:29 pm #27047
From Monarch Labs one of the leading suppliers of medical maggots.
Maggots do not bite. They do not have teeth. They do have modified mandibles called “mouth hooks,” and they have some rough bumps around their body which scratch and poke the dead tissue, one of the mechanisms that debrides the wound. It is similar to a surgeons “rasper,” but on a microscopic scale.
The maggots are so small when applied that they cannot even be felt within the wound. Those patients who already have wound pain before beginning maggot therapy, perhaps due to exposed nerves or other reasons, may have some pain during maggot therapy when the maggots become large enough to be felt crawling over those nerves (usually at about 24 hours). Those patients should be given access to pain medications (analgesics); but if pain medication is inadequate to relieve the discomfort, the maggots can be removed early. Once the dressings are removed, the maggots will crawl out and the pain should cease immediately. If further debridement is necessary, another MDT dressing can always be applied later. It should be used only for a brief period, until the patient is uncomfortable.
How do you get all of the maggots out?
The maggot dressing is removed as soon as the maggots have finished secreting their proteolytic (tissue-dissolving) enzymes (within 48-72 hours). At that time, their natural instinct is to leave the wound and crawl away as quickly as possible. So when the dressing is opened, the maggots will be “at the gate,” eagerly awaiting their release. If any slow growing larvae remain, they can be removed with a simple wipe, wash, or irrigation. If they are hiding within a crevice, simply cover the wound with saline-moistened gauze, and replace it three time/day; the remaining maggots will leave the wound within the next 24 hours (as soon as they feel it is safe), and bury themselves in the gauze.
Note: If doing this the “old school” way with flies depositing eggs directly consider the life of the Phaenicia (Lucilia) sericata, the green blow fly Chart above. It will take the 8 to 24 hours for the Larva stage to begin it’s work.
Additionally you could harvest eggs using a sacrificial piece of meat, if in a homestead type situation vice truly stuck in the boonies. In theory this could reduce possible infection risk from flies.
The eggs of L. sericata are usually white, but can be a pale yellow. They are often deposited in batches or masses. The eggs are elongated with one end tapered slightly, and are approximately 1.5 mm long.
From University of Florida, Institute of Food and Agricultural SciencesMay 7, 2016 at 9:33 pm #27048
Id imagine for most they would not be able to handle even the thought of it.
Actually many people have been very excited about the use of maggots, primarily because they’re faced with far worse alternatives such as amputation or death.May 10, 2016 at 11:32 am #27129MaxKeymaster
Note: This is not Max’s response/content. Just a glitch from the transition to subscription.
My name is Mike, I’ve been lurking here a while. Since this is something I actually have experience with, I thought I’d chime in.
I am an RN and work in a diabetic wound clinic, and we have used maggots on several patients as part of a study (still waiting on approval to use them as needed).
The ones we use come in polyethylene mesh bags, so we don’t have to worry about a big maggot roundup later on.
They do a great job of cleaning up a wound, and most of our patients don’t even feel them at work.
Some maggots will dine on healthy flesh, but the ones from the green fly in the picture do not.
MikeMay 10, 2016 at 2:25 pm #27135
Well first off welcome to the Forum Cooter!
I truly appreciate your adding this real world point of view.
I am confident that this could be a true lifesaver in a “Post-Event” world.
Thanks again for contributing.May 11, 2016 at 8:33 am #27159MaxKeymaster
Note: This is not Max’s response/content. Just a glitch from the transition to subscription.
Thanks for the welcome.
So far, we have used maggots for about 2 applications, spaced 4 days apart. Say 8 days total. They really clean up a wound fast. You have to keep a gauze dressing moistened with saline or just water, and don’t compress them too much with the bandaging. I read somewhere that soldiers in the Civil War would be laying in the hospital “praying for the maggots to come.”May 11, 2016 at 9:42 am #27163
I read somewhere that soldiers in the Civil War would be laying in the hospital “praying for the maggots to come.”
Considering what the alternative, I can see why.
That reminds me I have a copy of “A Manual for Military Surgery, for the use of Surgeons in the Confederate States Army – Second Edition 1862”, be interesting to see if they mention it (neat historical book, not for advice).May 11, 2016 at 10:51 am #27169Mike QParticipant
If memory serves Medical School before and during the Civil War was 2 years long. The 1st year you were taught all they knew and then repeated it to make sure you remembered it…
Also during the Civil War the the beginnings of modern battlefield casualty care was invented. Jonathan Letterman (Union) created the ambulance core with dedicated teams of men whose job it was to pick up the wounded, provide basic battlefield care, and move them to dedicated aid stations where doctors performed medical care. Often with the removal of the affected limb. Dedicated wagons were built which carried medical supplies and could move men were used for the first time. They could carry 6 men laying down and 6 men seated along with the medical personnel.
Jonathan also changed from a regimental hospital system to more local field hospitals. Each field hospital depot had 1 chief surgeon, 3 operating surgeons, and 9 assistants. He also instituted categories for the wounded – severely wounded, lightly wounded, and mortal wounded. Severely wounded were treated first, followed by lightly wounded.
In previous wars the litter bearers were pulled from units to simply clear the field. Most often the litter bearers were simply the guys most in trouble with their units and their chore was used as a punishment. They had no specialized medical training so could do little other than carry the broken bodies and give water. Often times the wounded simply laid there fore days.
During the Civil War the limbs were removed because of the infections caused by the wounds. Remember a majority of the bullet wounds were caused by mini-balls. These rounds were so large, .68 caliber or so if I recall, and moving at such slow speeds, that when they hit they sometimes didn’t even break the skin. However the organs and more importantly the bones underneath shattered. Imagine what a mess a shattered bone will do to the inside of the human body… When the rounds did penetrate the body they often took with them the lead itself from the round, the shattered bones, and the clothing through which the bullet passed. All of that combined is a recipe for infection… Hence dealing with one “external” injury, i.e. the severed limb end, had a better chance of survival than the bullet wound and above mentioned internal damage. Therefore the order of the day was amputation.
Antibiotics weren’t available at this time, so each individual had to survival without any real drugs. They did have some very basic drugs but so little supply of it that it wasn’t widely used.
The actual battlefield deaths were about two thirds of the deaths during the war. The rest were due to illness between battles, and sickness afterwards due to wounds.
There never seems to be enough time to do it right, but there is always enough time to do it twice.
CRM Sept. 2014, CTT 1505, CTT July 2015, RC-Rifleman 1502, CP Nov. 2015, FoF March 2016, CCW May 2016, FoF Oct. 2016, FoF Nov. 2016, CLC April 2017, FoF Nov. 2017, Alumni weekend Aug. 2018, CQB Dec. 2018, CQB May 2019May 21, 2016 at 1:17 pm #27366HiDesertRatParticipant
speaking of the Civil War…
Attachments:You must be logged in to view attached files.May 21, 2016 at 1:28 pm #27368HiDesertRatParticipant
The reality of the War of Northern Aggression was illustrated in an article I once read in JAMA, Journal of the American Medical Association. A surgery, an amputation, resulted in a 300% mortality rate! The surgeon in his haste, cut his assistant who subsequently exsanguinated, he also ‘nicked’ the nurse, who, along with the patient
expired a few days later from massive infection (sepsis). The state of the operating theater would not improve until the advent of the use of carbolic acid as a disinfectant, first used by Joseph Lister in the late 1860’s. Antisepsis was the new name of the game.May 12, 2017 at 3:55 pm #44498
Yearly bump, information for new members.May 12, 2017 at 4:43 pm #44503wheelseeParticipant
The Crimean War saw Florence Nightingale identify major medical/health issues surrounding war. Per one article, Ten times more soldiers were dying of diseases such as typhus, typhoid, cholera, and dysentery than from battle wounds.
I cannot find the reference now, but in my training years (many years go), it was discussed that the Queen was so impressed with Nightingale’s work that the British surgeons could not operate without Nightingale’s approval.
It was through her work, meeting with Queen Victoria and Prince Albert (1856), and giving evidence to a Sanitary Commission (1857), that helped with the formation of the Army Medical College in Chatham in 1859.
Which is heavier - a soldier's pack or a slave's chains? Napoleon
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If you tolerate evil, you yourself are evil.
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William, in The Republic
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