Doctors healed a 46-year-old diabetic mans infected foot using maggots, honey and human placenta, after regular antibiotics didn't work.
Foot ulcers are a common complication of diabetes. Poor circulation, nerve damage and high blood pressure can leave those with diabetes susceptible to ulcers.
When the patient presented to a hospital in Iran, the pressure wound on his heel — which was 7cm in length — had been present for about six months.
Although the patient had already tried to heal the infection using conventional treatments such as wound cleansing and antibiotic therapy, these failed to work.
Instead, doctors treated the infected wound using the unusual methods, some of which are available on the NHS.
The case study published in the International Journal of Surgery Case Reports revealed wound cultures from the patient, who had a 15-year history of type 2 diabetes, had a bacterial infection resistant to multiple drugs.
Doctors removed the dead tissue from the man's heel to create a clean area for the skin to recover.
Then the patient underwent four rounds of maggot therapy — a treatment that may sound extreme, but is sometimes used by NHS doctors to fight infection.
Also known as maggot debridement therapy, specialists use green-bottle fly larvae that feed on dead tissue, releasing chemicals that break down bacteria and stimulate the healing process.
These maggots are specially bred in a lab using eggs that have been treated to remove bacteria.
They are placed on the wound and covered with gauze, under a firm dressing, which keeps them on the wound and out of sight. After a few days, the dressing is cut away and the maggots are removed.
Following the maggot therapy, the wound was dressed with Med-honey — a specialised honey with demonstrated antibacterial and anti-inflammatory properties.
The dressings were changed every 48-hours to maintain a moist wound environment and support the healing process.
Simultaneously with Med-honey application, the wound received Human Amniotic Membrane (HAM) treatment, which uses the inner part of the placenta. The patient had eight sessions over a month.
First, the membrane was meticulously cleaned and disinfected to make sure it was safe. It's bioactive components, including growth factors and cytokines — crucial in helping the body's immune and inflammatory responses — were preserved.
'The application process resembled the careful unfolding of a precious tapestry, with the membrane acting as a scaffold for cellular activities,' study authors wrote.
Growth factors within the membrane helped to heal the damaged tissue, while the cytokines provided biological responses within the wound 'microenvironment', the study explains.
The membrane's barrier function not only shielded the wound from external threats, such as microbial invasion but also retained moisture, helping tissue regeneration.
Over a three-month period doctors saw a 'remarkable improvement' with a significant reduction in wound size, decrease in inflammation and infection and the wound eventually closed.
