The Prague Post Online: News: Alternative cures gain popularity

November 22nd, 2008

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Alternative cures gain popularity

Ministry considers new laws for treatments such as larval therapy

August 22nd, 2007 issue

By Ayesha Khan

For the Post

Alternative medical treatments appear to be on the rise, including larval therapy, an often off-putting treatment in which maggots eat the dead tissue of patients.

While the Health Ministry keeps no official figures on larval therapy, at least one doctor at Motol Hospital in Prague 5 saw the number of patients willing to try it increase from just a few in 2003 to an estimated 150 patients in 2006.

“Nature’s way is the best way,” says Dr. Karel Novotný from the cardiovascular unit of Motol Hospital.

He says such treatment, often used for burn wounds or ulcers, should be used in connection with conventional treatments, especially as a last resort when nothing else seems to work. An estimated 40 to 50 practitioners offer such treatment nationwide, he says.

Such treatment is controversial in the medical community because it can do more harm than good, says Dr. Jaroslav Blahoš, president of the Czech Medical Association of J.E. Purkyně.

“[We have] always considered alternative treatment methods nonscientific and potentially dangerous for patients,” Blahoš says.

But Novotný counters that such treatments, which have been gaining in popularity since the 1980s, can succeed where more conventional methods fail.

“I was treating a patient who suffered from a case of very poor blood circulation,” Novotný says. “To avoid leg amputation … necrotic tissue had to be removed,” but all conventional methods had been exhausted.

Maggots crawled on the man’s wound for three days to remove dead tissue, and doctors managed to save his leg, Novotný says.

This feeling of maggots crawling on one’s body, which Novotný describes as a “shivering” feeling, may have kept the treatment from more common use.

Getting over the ‘yuck factor’

Patients are conscious when maggots are placed on the infected area, Novotný says. A covering is used to wrap the wound, which lets air in for the maggots to breathe.

If patients prefer, Novotný can numb the area with anesthetic, he says. Over the past four years, only three or four patients have stopped treatment because they couldn’t stomach it, he says.

But it’s the “yuck factor” of maggots that has kept the treatment from more mainstream use, says Pascal Steenvoorde, a surgeon who uses such therapy at Leiden University Medical Center in the Netherlands.

People associate maggots with rotting and decay, but, as more find out about the positive aspects of such treatment, more accept it, Novotný says.

“I think it’s more psychological, rather than anything else,” he adds.

Steenvoorde says maggot therapy has an edge over conventional treatment, since maggots have a unique digestive system that breaks down only dead tissue and leaves healthy tissue unharmed.

In addition, such treatment is faster than all other nonsurgical treatments and patients heal more quickly, says Iain Whitaker, a doctor at Morriston Hospital in the United Kingdom who has done considerable research on the subject.

For example, maggot-treated wounds heal in about 10 days, on average, compared with about four weeks of healing after conventional treatment, according to his research, Whitaker says.

Health officials here may soon draft legislation with basic requirements for these types of therapies.

“Alternative treatment is not official and therefore there is no legislation to support the practice,” says Health Ministry spokesman Tomáš Cikrt.

However, the ministry is first seeking opinions from professionals on the issue, Cikrt says.

“Doctors and health insurance [providers] must discuss the results of these treatments to determine which therapy is good to give public money to, because we have a limited budget and medicine is very expensive,” Cikrt says.

Novotný charges 2,500 Kč ($122) for a three-day maggot therapy application. That price is about 40 percent lower than conventional treatment, which usually includes surgery, he says.

The maggots come from a breeding farm in Moravia and are transported in special plastic containers fitted with air filters.

Maggots have been healing wounds for centuries, but didn’t enjoy a resurgence in popularity until the 1980s. Such alternative therapy is currently available in most European Union countries.

Ayesha Khan can be reached at news@praguepost.com

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