I will admit that maggots have a gross factor that even I am not immune to, having in fact had maggots crawling all over my arms and hands at one point made me nauseous for a solid week. We had found that our little hen, Lucky, had sustained an injury at some point, and within a few days, her wound was crawling with maggots.We don’t know how Lucky had gotten injured, and we had been out of town for a day or two, but Lucky has a way of finding the tiniest spaces, the most efficient means of escaping, and sometimes she has gotten hurt.  Lucky had an infection, and I feared the maggots were only a sign of fatality, that surely my little hen couldn’t survive this assault.

We called our vet who, thankfully, had a vet on staff who didn’t know the most humane way to euthanize a chicken with that level of injury, and I decided that if Lucky wanted to fight, I would do my level best to help her. My daughter and I brought her home wrapped in a towel, maggots and all, and I decided the first thing to do was to bathe Lucky. Into the washtub we placed the bird and began to rinse the area with saline. At the first rinse, maggots swarmed out of Lucky’s wound and onto my hands. They begged to escape by crawling my arms, my hands, and trying to make their way into my sleeves.

I had no dead skin on me, so there was no food source for them, but feeling maggots crawling everywhere certainly was a unique scientific experience that I had never before experienced. I was thinking maggots=death.  Poor little Lucky. We would hold her, keep her at the house, which she actually dearly loves, and let her ease down peacefully. Lucky had no ideas of peace about her and began to fight my cleaning ministrations. I had no hands free to get the maggots off myself, and tried to just keep rinsing and silent. Added emotional drama didn’t seem to be helpful, so I focused on trying to determine the life cycle of the maggots rinsing down the drain and into my arms, young maggots and old maggots. Lucky had had the injury for a few days.

When I cleaned Lucky off, I found that she had sustained a puncture injury, perhaps from a rooster’s mating attempt, perhaps from jumping off her perch, or from some means I hadn’t imagined. Her puncture injury was right near the cloaca, and egg-laying must have been extraordinarily painful. My first response was to place Lucky in lowered light levels to stop her from laying, signaling to her body that it needed to rest. I turned down the lights, continued rinsing, and when I had finished flushing the wound with sterile saline to remove all the dirt (when injured, chickens will dust bathe, which does serve a purpose, but that is another story about Brownie, who dust bathed and stopped  hemorrhage).

I applied antibiotic ointment. Lucky hated it. She kept trying to straighten her feathers, and she didn’t like the way the oils stuck to them. I rinsed the maggots down the drain. And, put Lucky in the dog crate we keep for purposes like this, with water mixed with a good amount of yarrow and sage (both help stop bleeding and “weeping” or moist infections) and a little oxytetracycline, but only a small amount of the antibiotic. Lucky, as with most of our birds, hates drinking water with any additive except herbs. She will avoid any medicated water, waiting until she gets fresh water to drink anything. Since she was already stressed, I merely put herbs in her water, turned down the lights, told her we loved her, petted her gently, made her a soft nest and headed out of the room. Lucky turned away from us unhappily in the darkness and proceeded to try to groom the ointment out of her feathers. It’s always a good sign when a bird grooms themselves, because it shows that they are well enough to try to order their feathers and keep themselves clean, much like when you know you have recovered from the flu when you want to brush your hair and shower finally.

I woke up the next morning trying to steel myself for the inevitable silence I felt for sure would greet me. I told myself that we did the best we could, we had loved her, we had cared for her, we must let her go if it was her time. I came downstairs and I heard pecking, and an inquisitive chirp that Lucky does so well when she is curious. Lucky was up and eating and drinking. Her breathing was still relatively rapid, a sign of stress, and her surrounding infected area was still very warm and read to the touch. The puncture wound in the light of the day was sobering. It was the size of an egg, perhaps that area having been stretched by egg laying, had blackened tissue around the edges, and there was a deep, deep scab that seemed to hang heavily from her delicate skin near the cloaca. It looked painful. Maggots were still crawling, but not as plentiful.

I was disturbed by the blackness, the dead skin, and I flashed back to debridment of wounds, how to care for burns and deep wounds, which to the uninitiated, means scraping off the dead tissue to release live tissue underneath to prevent the infection from festering. Inevitably this is painful because by scraping off dead tissue, the live tissue underneath gets pulled off in the process. I had no idea how to do this with such a deep wound and no desire to inflict that on my precious little hen. Then I thought of the maggots. The night before the maggots had been plentiful, but there hadn’t been so much dead tissue, and the fact of the matter was, the maggots had been cleaning the wound of dead skin, probably painlessly because Lucky didn’t pick the maggots off and eat them the way most chickens grab worms. She left them in place for a reason, and looking at that blackened skin, I vowed to do the same. I could not find a way to remove the dead skin to let the wound drain more effectively than the maggots had.

Lest you think this is a crazy idea, maggots have been used in medical settings to remove dead skin. Maggots actually help a wound heal, and it works in people, is considered a valid medical treatment for infected wounds. Science Daily just covered scientifically “improved” maggots bred for wound debridement:

Sterile, lab-raised green bottle fly larvae are used for maggot debridement therapy (MDT), in which maggots are applied to non-healing wounds, especially diabetic foot ulcers, to promote healing. Maggots clean the wound, remove dead tissue and secrete anti-microbial factors. The treatment is cost-effective and approved by the Food and Drug Administration. However, there is no evidence from randomized clinical trials that MDT shortens wound healing times.

With the goal of making a strain of maggots with enhanced wound-healing activity, NC State researchers genetically engineered maggots to produce and then secrete human platelet derived growth factor-BB (PDGF-BB), which is known to aid the healing process by stimulating cell growth and survival.

What?? Maggots help us? Nature created something crawly that serves a purpose? It sure did for Lucky. I let the smaller maggots continue to clean the wound, and by that evening, the black tissue around the wound was gone, Lucky was moving more, and the scab started to show signs of loosening around the edges. I continued with the herbs in the water, provided fresh greens, lowered light to stop her laying, and provided small items of interest for her to dig out of her food dish, sunflower seeds, lettuce leaves, a piece of bread (which she didn’t really eat but dearly loved to shred), and Lucky continued to recover. I also continued to give her small doses of antibiotics in her water, and I changed it three times a day, added a separate container of electrolytes, and within a few days, the wound was healing and the maggots were gone. I didn’t kill them. I don’t know where they went.

We brought Lucky back to the garden for a few hours everyday, and at one point when I picked her up, the scab on her loosened at the edge a yellowish-lymph and pus-filled liquid ran from the wound and onto my hands. It was thin and had lots of clear fluid in the mix, and while I struggled to determine what industrial strength cleaner I would need to wash my hands, I did compress the area a bit more, and the wound drained on it’s own. Within a day or two after that, the big scab fell off completely, and there was only healthy pink tissue showing.

A large, pink organ showed beneath the skin, and when I looked it up in Nature, I found that a chicken has an immune organ called a bursa, and this swells when a chicken fights infection. Turns out that scientists have been studying chicken immune systems for the last 60 years to determine where cancers in humans originate, and the bursa in chickens is similar to our bone marrow producing immune cells (think of human dysfunction with this as it manifests in leukemia–fascinating research on the ways animals inform our understanding of ourselves, if you wan to read it).

As Lucky continued to heal, the swelling in her bursa went down, the infection never resurfaced, and within two weeks, after that Lucky’s wound healed over completely. It seemed as if magic was visited upon us, and everyday I went to the garden and rejoiced in Lucky’s persistent attempts to escape her pen to chase off the other hens from her favorite digging place.

Maggots. Who would have believed that maggots could be so healing? Who would have believed that maggots can do what modern medicine cannot, clean a wound of dead tissue so easily and capably that a seemingly fatal wound and infection heal without a trace. We live in an amazing world. I had stumbled on what battlefield surgeons noticed years ago: maggots help heal wounds and clear infections.

Maggots are efficient consumers of dead tissue. They munch on rotting flesh, leaving healthy tissue practically unscathed. Physicians in Napoleon’s army used the larvae to clean wounds. In World War I, American surgeon William Baer noticed that soldiers with maggot-infested gashes didn’t have the expected infection or swelling seen in other patients. The rise of penicillin in the 1940s made clinical maggots less useful, but they bounced back in the 1990s when antibiotic-resistant bacteria created a new demand for alternative treatments. In 2004, the U.S. Food and Drug Administration approved maggot therapy as a prescription treatment.

Although anecdotal reports suggested that maggots curb inflammation, no one had scientifically tested the idea. So a team led by surgical resident Gwendolyn Cazander of Leiden University Medical Center in the Netherlands siphoned samples of maggot secretions from disinfected maggots in the lab and added them to donated blood samples from four healthy adults. The researchers then measured the levels of so-called complement proteins, which are involved in the body’s inflammatory response.

Every blood sample treated with maggot secretions showed lower levels of complement proteins than did control samples—99.9% less in the best case, the team reports in the current issue of Wound Repair and Regeneration. Looking closer, the researchers found the broken-down remnants of two complement proteins—C3 and C4—in the secretion-treated samples, suggesting that the secretions had ripped the proteins apart. When the team tested blood samples from postoperative patients, whose wounded bodies were already scrambling to heal, they found that maggot secretions reduced the levels of complement proteins by 19% to 55%.