MAGGOT MAGIC – HOW MAGGOTS SAVED A LEG

Lynn Dow posted this on her Blog: Stories from My Life as a Nurse.

From time to time I plan to publish a post about an older nurse and his/her experiences that will add a richer appreciation of the evolution of our current practice. I hope you enjoy Lynn’s story.

 

Maggot wound repair Nightgale talesMr. T. came from Texas and while driving a gasoline tanker in upstate New York he had the misfortune of falling asleep and rolling the vehicle which quickly burst into flames. He was lucky to survive, however, his right leg was very badly burned and in need of a skin graft. He ended up on the unit I was working on that summer in 1958.In the early years of skin grafting  often the procedure used a pedicle flap graft which meant the skin being grafted was only partially detached and applied to the area in need of the graft .This was done to ensure there would be a viable blood supply.  In Mr. T’s case the graft to cover the area on his right shin was obtained from the back side of his left calf; his left leg was crossed over the right and the skin loosened but still attached was sewn over the area requiring the graft.  A delicate procedure, to say the least – limiting the patient’s activity to sitting with legs crossed and  sewn together either on bedrest or sitting in a wheel chair for several weeks until the graft took hold.

Mr. T followed his postop instructions to the letter, sitting in the wheelchair next to the window, barely moving, so not to disturb the graft. In spite of his attentive behavior within a few days an awful odor developed indicating the wound was infected.

It was the middle of August and hotter than hell.  There was no air conditioning in hospitals then but we did keep the windows open in hopes of catching a few breezes.  What we caught more often were flies and this became Mr. T’s good fortune – the flies dropped their larvae in the form of maggots onto his decaying wound.  The maggots loved it and ate until so swollen with matter they could not move, whereupon, Mr. T would take a clamp like a pincer and kill the little creatures.  The wound cleaned up in a matter of days with no signs of infection.  Remember this was before the use of antibiotics for wound healing.  It just required an open window, a few flies, a Kelly clamp and a vigilant Mr. T.

The graft took, his legs were separated and Mr. T. returned to his beloved Texas in time to celebrate Halloween with his children. He had only a slight limp to show for all of his discomfort.

Lynn wrote a book called Nightingale Tales: Stories from My Life as a Nurse, which I have highlighted on a past post: Nightingale Tales on November 15, 2017.

nightingale tales

 

Nightingale Tales

My new project involves interviewing my classmates from nursing school. We “older nurses” are dying off. Who will be around to tell our stories?

As I gear up to start this project, I’m educating myself in the art of interviewing. In the meantime, a serendipitous thing happened. Lynn Dow, RN, wrote about her long career in nursing in a new book: Nightingale Tales: Stories from My Life as a Nurse.

Lynn Dow entered nursing school in 1956, three years before I did. She attended the diploma program at the University of Rochester, which like my diploma program at Saint Peter’s School of Nursing in New Brunswick, New Jersey was three years long without any summer vacation breaks. The stories she shares of her nursing school days entertained me the most since my experiences so mirrored hers.

In her book, she reminded me that after a patient went home we had to strip the bed and then wash it. Yes, the plastic coated mattress and exposed metal coil springs were washed by hand. When the bed dried, we made it up for the next patient. There were no housekeepers at this time. Two cranks at the foot of the bed were used to raise up the head or to “gatch” the knees so the patient wouldn’t slide down. Later, a third crank was added that raised or lowered the bed. I remember having black and blue marks on my shins from hitting the cranks that were left on the bed instead of taken off and stored somewhere, like on a window sill.

Lynn recalls when cardio-pulmonary resuscitation was still in its infancy, a surgeon might bypass this effort and “crack the chest.” This rarely was successful. Once when I worked in the recovery room my patient went into cardiac arrest. Her surgeon dragged her off the stretcher to the floor, cut her open and pumped her heart with his bare hands. She was an old woman and I felt at the time he did this for the experience rather than to revive her.

Commonly, student nurses staffed the hospitals because there was a shortage of registered nurses, and students were a cheap substitute. In the third year of school, students were put in charge of a ward on the evening or night shifts. Lynn reminds the reader that the student nurses were “teenagers, too green to realize the extent of our responsibilities.” Sometimes the students worked a “split shift,” covering baths and meds in the a.m. and returning to help with dinner trays and get the patients ready for bed in the evening. Before I graduated from nursing school this “abuse” of student nurses was no longer allowed.

Nightingale Tales goes on to cover Lynn’s long nursing career and is filled with educational information and surprising vignettes. While I am especially glad she shows us nursing in the “olden days,” her book also depicts the advancements in current nursing practice. But she feels that possibly “the nurturing aspect of nursing has given way to technology.”

Read her book and decide for yourself.