Medical maggots have been making a comeback, but it bugs wound clinicians that Canadians can’t get access to maggots the way Americans can.
Creepy as it sounds, maggots are actually very helpful in treating serious wounds. They eat dead tissue and destroy bacteria, while leaving healthy tissue untouched.
For people who are facing the horror of possible amputation, maggots can be a practical, inexpensive and efficient solution.
“Most patients with chronic, draining, stinking, limb-threatening wounds, often having already suffered weeks or months with them, recognize that 48 hours or more of maggot therapy is much less ‘icky’ and scary than their wounds,” says Dr. Ron Sherman, director of Monarch Labs in Irvine, California, which supplies maggots to hospitals in Canada and the U.S.
In order to be effective, maggots must arrive at the bedside starving and be used right away. So timing is crucial.
But here’s the snag. Health Canada recently reclassified maggots as “drugs” instead of “devices,” and this has slowed to a crawl the process of getting them across the border.
Until last year, it took about 24 hours for them to arrive. But it can now take up to three weeks, according to Christine Pearson, a B.C. nurse and board member of the Canadian Association of Wound Care, who spoke to the Canadian Medical Association Journal about the issue.
“The problem with shipping maggots is that they are not only live, but highly perishable. They can not be fed during their journey, or else they will no longer be ‘hungry’ and effective upon arrival at the bedside,” says Sherman.
Maggots are approved by the U.S. FDA but not Health Canada. No company in Canada can manufacture or market maggots until a large clinical trial is done here, but funding is scarce and bureaucratic red tape is abundant, according to Sherman.
Monarch has been sending medical maggots to Canada for 18 years. Last year, they received about 50 orders for maggots, by clinicians in Alberta, British Columbia, New Brunswick, Nova Scotia, Ontario and Quebec. But with the new rules, reported Pearson, ordering maggots is a big hassle for Canadian doctors and nurses.
The best solution would be to set up a maggot-producing laboratory in Canada, says Sherman, and thereby cut down on the delays and frustrations of importing creepy, crawly insects across the border.
Monarch Labs is actively seeking research funding to do Canadian clinical trials of medical maggots.
Then, Monarch would request marketing clearance “if the results are anywhere near as favourable as they have been in the U.S. studies,” he adds.