(2) what assessment has been made of the potential effect on costs of the use of maggot debridement therapy in the NHS; and if she will make a statement;
(3) what recent representations her Department has received on maggot debridement therapy; and if she will make a statement;
(4) what (a) clinical trials and (b) other studies have taken place on maggot debridement therapy; how much was spent on such activity in each of the last three years; and if she will make a statement;
(5) what assessment has been made of potential adverse side effects of maggot debridement therapy; and if she will make a statement.
The information requested regarding the numbers of patients treated with maggot debridement therapy (MDT) is not held centrally. However, there is one such medical grade maggot which is now available on prescription in the United Kingdom so that general practitioners can use MDT in the community. There were around 1,100 prescriptions written for dispensing in the community for LarvE (the commercial brand name for the sterile maggots) in 2005, which does not include hospital use.
The National Institute for Health and Clinical Excellence has advised the national health service that the choice of debriding agent for difficult to heal surgical wounds should be based on comfort, odour control, other aspects relevant to patient acceptability, the type and location of the wound and total costs. The actual costs of treating difficult to heal wounds have not been measured. If specific services for the management of difficult to heal surgical wounds were to be developed throughout the NHS, there would be organisational and cost implications, which would need to be evaluated.
My noble Friend, the Minister of State for Health (Lord Hunt), has received an invitation from the hon. Member for Bridgend (Mrs. Moon) to visit Zoobiotic Ltd. My hon. Friend the Minister of State for Public Health (Caroline Flint) has received a letter from the right hon. Member for Sheffield, Central (Mr. Caborn) regarding the issue of MDT.
The Health Technology Assessment Programme funded a trial of MDT to be undertaken by the Department of Health Sciences of the University of York. The study started on 1 June 2004, involving 600 patients with venous leg ulcers who were randomised to one of three treatment groups to compare their effects on healing and debridement times. The Government, through the Health Technology Assessment Programme, agreed to fund this study, which had been several years in the planning and cost over £700,000. The report of the research is expected in early 2009.
MDT may cause pain or discomfort, particularly in patients already experiencing wound pain. This usually occurs about 24-36 hours into therapy and worsens as the larvae grow larger, Painkillers should help to relieve the pain; otherwise removing the maggot dressing provides immediate relief. The maggots should be contained within the wound. If they escape onto unprotected skin around the edges of the wound, the larvae secretions can cause a rash on the skin which resembles a superficial burn.