Maggot Therapy
A Handbook of Maggot-Assisted Wound Healing
Wim Fleischmann, M.D.
Department of Traumatology and
Reconstructive Surgery
Bietigheim Hospital
Bietigheim-Bissingen
Germany
Martin Grassberger, M.D., Ph.D.
University of Vienna
Vienna, Austria
Ronald Sherman, M.D., M.Sc.
Departments of Pathology & Medicine
University of California
Irvine, California
USA
Thieme
Stuttgart • New York
Library of Congress Cataloging-in-Publication Data is available from the publisher
This book is an authorized and revised translation of the German edition published and copyrighted 2002 by TRIAS Verlag, Stuttgart, Germany. Title of the German edition: Erfolgreiche Wundheilung durch Maden-Therapie. Biochirurgie: Die wieder entdeckte Behandlungsmethode bei diabetischem Fuß und anderen schlecht heilenden Wunden.
Translator: Suyzon O'Neal Wandrey, Berlin, Germany
© 2004 Georg Thieme Verlag,
Rüdigerstrasse 14, 70469 Stuttgart,
Germany
Thieme New York, 333 Seventh Avenue,
New York, NY10001 USA
Cover design: Matina Berge, Erbach
Typesetting by Satzpunkt Ewert GmbH
Printed in Germany by Druckhaus Beltz,
Hemsbach
ISBN 3-13-136811-X(GTV)
ISBN 1-58890-232-3 (TNY) 12 3 4 5
Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book.
Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers' leaflets accompanying each drug and to check, if necessary, in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user's own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed.
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Preface
This volume and the German edition that preceded it are landmarks in maggot therapy history. Together, they represent a milestone in the 21st century revival of maggot therapy. Seventy years ago, no one ever imagined that there would be the volume of information or the popular demand to warrant an entire book on the topic of maggot therapy. Just 10 years ago, almost no one believed that the world would again see the widespread use of maggot therapy or the need for an entire book on this topic. But this book is now surely warranted, given our expanding knowledge of this awesome medical practice, and the growing interest and use of biodebridement to aid in the care and healing of wounds unresponsive to more conventional medical and surgical therapies.
Drs. Fleischmann and Grassberger brought their wealth of knowledge and experience to the original German edition, which explored the history, biology, pathology, mechanics-the science, philosophy, and art-of maggot therapy. Now, 2 years later, this volume expands on that work with the results of new research, more chapters, and additional references, and brings the entire body of work to the English-speaking world. Case histories illustrate the varied uses of maggot therapy. Technical problems and their solutions are discussed.
The clinical photographs are not for the weak-hearted, nor for those with weak stomachs. They are included because they accurately illustrate the wounds that often require maggot therapy: gangrenous, life- or limb-threatening wounds that have progressed for weeks, months, or even years despite the best of modern medicine and surgery. No matter how much the reader may be disgusted by maggots, after reading the case reports the reader will come to agree with maggot therapy patients and practitioners: the smelly, draining, gangrenous wounds are much more disgusting than the maggots.
Whether a student of biology, a prospective patient, or a medical professional considering the use of maggot therapy in your own practice, this book will inform, amaze, and entertain you. You will be engrossed. Enjoy it.
Ronald Sherman
Autumn 2003
Contents
Transmission of Disease by Flies
Phaenicia (Lucilia) Sericata (Green Blowfly)
Stimulation of Wound Healing