Talk:Maggot therapy/Archive 1

Picture Issue

 * That picture really needs to be toned down/taken off. It's far too graphic for casual readers.**
 * On the contrary, the pictures seem to me to portray the therapy very well. What would you suggest in place of representation of maggots used in wounds, given that the article is about maggots used in wounds? Use of capitals in comments suggests to some readers that you are shouting. Signing your comments using four tildes is considered standard on discussion pages. Jimjamjak 11:54, 17 May 2007 (UTC)


 * I disagree with the argument that the hiding these images within links keeps people from seeing shocking or graphic images. This is the Maggot therapy article. You don't come across this article by accident, you choose to click on the link and if these pictures happen to appear on the site, the purpose is to enhance in educating the reader, not for shock purposes. There's no nice way of displaying maggot therapy... it's a bunch of maggots eating dead flesh. My problem with this issue is that this principle may be taken further and Wikipedia may become full of articles with "optional" pictures... annoying hindrances to the actual purposes of Wikipedia. From the content disclaimer: Wikipedia contains many different images, some of which are considered objectionable or offensive by some readers. For example, some articles contain graphical depictions of violence, or depictions of human anatomy.
 * For examples of these, see:
 * Burn (injury) image depicting burn injuries
 * Death clear picture of dead person
 * Bone fracture X-rays of fractured bones and surgeries performed
 * Man nudity
 * Sunburn sunburn injuries
 * The Holocaust nudity and death
 * Pogrom dead people
 * Nanking Massacre dead, beheaded people
 * Abu Ghraib torture and prisoner abuse people undergoing torture


 * After viewing these articles, I see no reason why maggot therapy should be singled out. There are plenty of uncensored graphic images depicting exactly what the article is about. Also, none of these articles have disclaimers warning readers that material may be too graphic to view. To censor one is to open the door in censoring all. -- VegitaU 05:01, 21 June 2007 (UTC)


 * Concur with VegitaU. Both WP:NDA and WP:CENSOR are absolutely crystal clear on this. We absolutely, positively do not censor or erect disclaimers for "graphic" (but otherwise valuable) content. While I understand the sentiment expressed, this is, frankly, not up for debate here; please do not remove the picture again. If you disagree with the policies, bring them up for discussion on their talk page or WP:RFC. As always, discussion is appreciated and encouraged. Thank you.Bullzeye Complaint Dept./Contribs) 07:57, 25 June 2007 (UTC)

Cleanup Required
"In the 20th century soldiers who were injured and not fit to go to the battlefield and left for several days having sustained compound fractures of the femur and large flesh wounds of the abdomen and scrotum. When they arrive at the hospital they had no signs of fever despite how serious their injuries and their prolonged exposure to the elements without food or water. When their clothes were removed `thousands and thousands of maggots that filled the entire wounded area' were found. To Baer's surprise, when these were removed `there was practically no bare bone to be seen and the internal structure of the wounded bone as well as the surrounding parts was entirely covered with most beautiful pink tissue that one could imagine'. This at a time when the death rate for compound fractures of the femur was about 75-80%."

Why is this poorly written, anecdotical note about wounded soldiers at the top of this article ? It should be at the bottom and cleaned up a bit. Moreover the source of this probably quoted material should be added.

Merger?
I have tagged the article Maggot therapy for merger into this article, for the simple reason that we do not need Duplicated Articles on Wikipedia. One is sufficient, how we wound up with 2 is a mystery. You are welcome to discuss this proposal below. Thor Malmjursson 16:07, 9 February 2006 (UTC) Thor's pet yack

Revision
The maggots used are those which eat dead flesh but not living human flesh (blowflies, usually the greenbottle Lucilia sericata, which is sometimes called Phaenicia sericata''). Some maggots, such as the screw worm Cochliomyia hominivorax, cannot be used because they eat live flesh.''

Can we just get rid of the article that's more amalgamated while preserving the above information, (beneficial and harmful species identification) in this article? Salva 19:33, 10 February 2006 (UTC)


 * I personally think what we should do is get together, look at the 2 articles, see what information is most usable out of both, and merge that information in to form a single article of the one topic. Information that you identified, like above, would be preserved.  Thor Malmjursson 20:18, 10 February 2006 (UTC) Thor's pet yack


 * Concede to the current revision? If so, then I'd like to know how to program Wikipedia to redirect from Maggot (t)herapy to Maggot (T)herapy.  This is the first random task edit that I've performed.  Thanks for your patience!  Salva 23:32, 10 February 2006 (UTC)


 * Its simple, Salva3. Once the 2 articles are merged together, and we create the new single article, Maggot Therapy, we use the old page, Maggot (t)herapy, as the redirect.  The text on the page is removed, and in its place, you simply put # REDIRECT  followed by the name of the article you wish to redirect to, in normal wiki format, enclosed in [ and ] brackets.  Its pretty straightforward.  Thor Malmjursson 02:17, 11 February 2006 (UTC) Thor's pet yack

Don't merge!, each type of necrotic wound has its own history and cultural significance which I believe will be lost in a merged page. Seriously though, why is there even a discussion? Merge it already. Maggot therapy has the proper capitalization, more history, and more links (5-0), so I'd probably merge into it. Maggot Therapy is the oldest (but by only a couple of weeks). Ewlyahoocom 19:27, 11 February 2006 (UTC)

Plagarism
If you check the sources, some content seems to be copied directly off the websites provided.

Redundant historical information
The following historical information was out of place in the article and should be merged with the existing historical sections.

In the early days of medicine, maggot infestations of wounds (myiasis) were inevitable, due to flies laying eggs in the wounds. Maggot-infested wounds tended to be less life-threatening than other wounds, so until antibiotics were developed it was common practice to leave the maggots. After antibiotics came into use, the presence of maggots became viewed as unhygienic. In recent years, however, use of specially sanitized maggots has developed as a treatment for various types of wounds such as leg ulcers and pressure sores, gangrene and other bacterial infestations, since the maggot will only eat the dead rotting infected flesh and leave the living flesh intact. It is especially useful for people with weakened immune systems or blood flow that become infected in the extremities, such as diabetics, and is particularly effective in treating diabetic foot problems. It has also been shown that presence of maggots deters gas gangrene from starting in a wound.

It may be that this ability of some maggots to disinfect and clean wounds originated in the wild when flies laid eggs in the wounds of live animals. It was beneficial for the maggots if the host animal was kept healthy and able to keep up with its herd, and not lag behind where a predator such as a lion or wolf would single it out and eat it before the maggots could finish their larval development and drop out of the wound and pupate. Also, preventing the wound from emitting a smell would stop wolves from tracking the injured animal by the smell from the wound.

According to a documentary on the History Channel, in 1822 an American mountain man, Hugh Glass &mdash; had been gravely injured by a grizzly bear attack and left alone in the wilderness to die &mdash; rolled himself onto a rotting log and had the maggots clean an infected wound on his back.

William Baer of Johns Hopkins University in Baltimore, Maryland was the first surgeon to actively promote maggot therapy in 1931.

MDT was successfully and routinely administered by thousands of medical physicians until the mid-1940s, when its use declined after new antibiotics and surgical techniques were developed in World War II.

Maggot therapy was occasionally used during the 1970s and 1980s, when antibiotics, surgery, and other modalities of modern antibiotics and surgical techniques failed.

As recently as 1989, military physicians at the Long Beach Veterans Affairs Medical Center in California collaborated with the University of California to further research MDT and the early conclusions are that MDT is an effective method to treat patients who would otherwise be subjected to amputations of limbs. MDT may even be preferable to modern surgical and antibiotic treatment in some cases.

More recently the use of Maggot Therapy for treating diabetic foot ulcers unresponsive to conventional therapy concluded that it was more effective and efficient in debriding non healing foot and leg ulcers in male diabetic veterans than was continued conventional care.

Akersmc 19:47, 30 May 2006 (UTC)

Anachronism
The item about Napoleon's chief surgeon gives 1829 as the date of his observation of the beneficial effects of maggots. This is obviously wrong, as Napoleon died in 1821 and spent the last years of his life in exile.

I am unsure of this. The item states it is Napoleon's surgon, however it does not say the surgon was in the service of Napoleon at the time of the comment. With Napoleon's popularity then (and now) he may have used that title even after Napoleons exile. My US$0.02...more research may be needed.

Napoleon doesn't only refer to Napoleon Bonaparte...

Practically speaking, unless there is further specification (e.g., Napoleon III, Napoleon Kaufman), yes it does.


 * Larrey died in 1842 so it's possible he was in Syria in 1829. Drutt 12:36, 6 May 2007 (UTC)

General Improvements
This article should avoid using any pictures, without at least issuing some sort of warning first, due to the graphic and rather disturbing nature that is common in such images. I would suggest linking to images of maggot therapy, while offering a warning beforehand.

Agreed. Since this complaint has been here for some time, and it's a rather obvious complaint, and indeed adding the image seems more like an act of vandalism than an actual improvement to the article, I removed the image. If someone wants to put it back, they can do it themselves with a link and an appropriate warning.
 * I certainly understand your issue with using the disturbing picture, but I do feel that the picture could improve the article.  I once tried to create a subpage for images of chronic wounds, but that was deleted.  Does anyone know a way to create a link to an image that's not on the page itself? Anyone have any suggestions for how to display this image tastefully and in a way that viewing is optional?  delldot | talk 19:02, 6 January 2007 (UTC)

Wikipedia is not censored. The picture is no different than the image one would get from reading the article. Honestly, by all means there should be media with anything medical. Darkahn 05:37, 28 March 2007 (UTC)

I would completely disagree with that; there should be no compulsion to see such a revolting picture. The present status quo should be maintained - the article text is educational to people about this particular type of therapy and the picture is most certainly dinner relinquishing "quality".

Wikipedia is not censored, it is not an improvement but a great step backward in time. --14.198.220.253 (talk) 09:49, 5 October 2013 (UTC)

Time-Locked Comment
In the Recent Clinical Experience section, this statement In just the last four years, over fifty scientific papers have been published that describe the medical use of maggots.

This is much too time-bound. If the original writer could specify something like "in just the period XXXX-XXXX, over fifty scientific papers have been published..."

A citation would be helpful, too.

* Septegram * Talk * Contributions * 14:00, 12 April 2007 (UTC)

Linkimage
I have reinstated the Linkimage template for the images of human wounds filled with maggots. User:VegitaU has repeatedly included the images inline on the page. I feel that these images are a perfect example of what the Linkimage should be used for. Joie de Vivre T 00:07, 10 July 2007 (UTC)
 * You should actually try reading the discussion above regarding this issue. Do not censor these images. It goes against Wikipedia policy. -- VegitaU 02:24, 10 July 2007 (UTC)


 * You should refer to WP:CIVIL. I was hoping to engage in a discussion with you but apparently you are more interested to issue orders.  Now what?   J o ie de Vivre  °  17:14, 13 July 2007 (UTC)


 * Now, I guess I revert them back. Have you read the points made above? It doesn't seem so since you haven't addressed them. -- VegitaU 17:22, 13 July 2007 (UTC)

Appearance in military SERE manual.
I haven't really had a chance to edit a page before, and don't know when it's appropriate. When I came upon this page(a result of factfinding over a probably infected cartilage piercing :, I knew I had read about this before in a survival manual. After a bit more searching, I rediscovered the FM 21-76 survival manual and its inclusion of steps to perform maggot therapy in the wild. It seems to me like a reputable testament to the therapy's conventional usage. So I present it here. The appropriate excerpt can be found at [] on page 27. Cheers ^^ —Preceding unsigned comment added by 24.58.114.72 (talk) 02:18, 12 September 2007 (UTC)
 * I also heard or read of a US prisoner of war in Vietnam (Possibly John McCain?) using maggot therapy on himself to get rid of dead tissue. (Disclaimer: I'm unsure if this incident is factual or fictional, and I'm unsure what the name was of said prisoner. I am not a supporter of John McCain.) Orville Eastland (talk) 21:47, 14 August 2008 (UTC)

Comment about entry refers mostly to the U.S.
Maggot therapy was first utilized during the 1930's and 1940's in the U.S. When its use waned after WWII, maggot therapy was re-discovered by a U.S. physician whom did the most clinical testing of it. The U.S. FDA was first to approve maggot therapy. While several other countries have followed the lead of the U.S. as it relates to maggot therapy, maggot therapy is primarily a medical therapy developed in the U.S.

Other living organisms used as a medical device
The article says: "Medical Maggots represent the first living organism ever allowed by the Food and Drug Administration for production and marketing as a prescription medical device"

Now somebody should provide a source for that statement or make some research in chronology because, as one example, there exists vaccines based on live bacteria (http://www.microbialcellfactories.com/content/5/1/23) - such as the typhoid vaccine. It is unclear to me whether the author was aware of it or considered bacteria 'living organism'.

I didn't consider live virus vaccines due to the virus' unclear status in terms of life (rather considered not a living organism).

Misiu mp (talk) 22:57, 16 September 2008 (UTC)

Citations for cost basis of maggot therapy
http://www.journalofwoundcare.com/cgi-bin/go.pl/library/article.cgi?uid=26973;article=JWC_15_10_465_469

This online version of a paper journal, the Journal of Wound Care (JWC) has published a study on the cost efficiency of maggot therapy. However, access to the article requires a paid fee. Is this something that can be used or cited here as a valid source? Sidewaystory (talk) 00:29, 14 October 2008 (UTC)
 * Yes, it is. There is no requirement that a source be available for free.  An academic journal of this sort is an excellent source. Nomoskedasticity (talk) 08:50, 15 October 2008 (UTC)

Advert tag
I mistakenly removed the advert tag from the article. On first glance, I didn't see the company and its product benefiting from several unsourced favorable POV claims. Rather than restore the tag, I sucked it up and made some neutrality edits. If my edits are insufficient, please restore the tag with my apologies. Matt Fitzpatrick (talk) 22:17, 24 October 2008 (UTC)

Size, species
Housefly larvae are positively miniscule, but blowfly larvae can be as big as mealworms. Which species are used for this and how big are they? (on House they were gigantic) —Preceding unsigned comment added by 75.73.70.113 (talk) 03:37, 26 December 2008 (UTC) They use blowflies, the article even says this.--69.155.113.22 (talk) 23:44, 6 March 2009 (UTC)

Advantages of Maggot therapy

 * Efficacy, as demonstrated in several small but significant controlled clinical studies.


 * Excellent safety record.


 * Simple enough that non-surgeons can use it to provide thorough debridement when surgery is not available or is not the optimal choice for other medical reasons. This means that it is also possible to provide surgical quality debridement as an outpatient or in the home.

I removed this section from the article. It has been tagged since October 2008 for citations. While some of what is said is fairly obvious, others like "excellent safety record" may require substaintiation....especially in view of the dangers of introduction of infection, and the need to follow processes for raising 'medical' maggots. prashanthns (talk) 17:21, 2 April 2009 (UTC)
 * Low cost of treatment.

New Source for Antimicrobial Activity of Maggot Excretions; "Mechanisms of action" section
"Maggot metabolites and their combinatory effects with antibiotic on Staphylococcus aureus."

Also, I think that the introduction to the "Mechanisms of action" section should be cleaned up. The intro says that debridement is the only use, but then goes on the mention antimicrobial activity. — Preceding unsigned comment added by Dwstultz (talk • contribs) 19:04, 6 December 2011 (UTC)

It appears that part of the text is (must be) missing, between "eats" and "Zacharias". (relevant section quoted within)
The section below, between lines of equal signs, is copied from the article as it stands right now. It appears that part of the text is (must be) missing, between "eats" and "Zacharias". Perhaps text that was there was accidentally deleted during an edit. Note the absence of closing quotation marks to match the opening quotation marks before "I have frequently [...]"; also note that if "Zacharias" is a name beginning a new sentence, then it and what follows makes sense. I leave it to others to research and amend the article in whatever fashion may actually be needed. It may be as simple as researching previous versions of the section, but I am not as familiar with wiki's tools as others may be, and prefer to alert competent helpers to a potential problem of any magnitude than to risk stepping wrong myself. I shan't be monitoring this further.

=
===== Dr. Joseph Jones, a ranking Confederate medical officer during the American Civil War, is quoted as follows, "I have frequently seen neglected wounds ... filled with maggots ... as far as my experience extends, these worms eat Zacharias, who reported during the American Civil War that, "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." He recorded a high survival rate in patients he treated with maggots.[5]

=
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134.48.160.30 (talk) 06:41, 1 October 2013 (UTC)