Reading: Matching Information to Paragraphs: Question 5

A Military surgeons treating soldiers on nineteenth-century battlefields repeatedly noted that wounds accidentally colonised by fly larvae during the days before a patient reached proper care sometimes healed faster and with less visible infection than wounds that had remained clean, an observation passed on informally between field doctors long before any formal clinical trial examined why this might be happening.

B With the arrival of antibiotics and increasingly sterile operating theatres in the middle of the twentieth century, doctors largely abandoned the deliberate use of larvae on wounds, regarding the practice as an unhygienic relic of an era before modern medicine, and its use in mainstream hospitals fell away almost entirely within a generation.

C Renewed interest emerged toward the end of the century as clinicians began encountering chronic wounds, particularly in patients with diabetes, that resisted standard antibiotic treatment and skin grafts; one hospital's decision to reintroduce sterile larvae under controlled conditions for a small number of otherwise untreatable cases is often cited as the turning point that returned the therapy to mainstream practice.

D The larvae used are a specific species of fly, raised in sterile laboratory conditions, that secrete enzymes capable of breaking down dead or dying tissue into a liquid form the larvae can then ingest, while leaving living, healthy tissue around the wound edge almost entirely undisturbed, a selectivity that surgical debridement with a blade cannot always match.

E In practice, a measured number of larvae are enclosed within a small pouch of fine, escape-proof mesh, which is placed directly against the wound and secured with an ordinary dressing; the pouch is generally left in place for two to three days before being removed and, if further treatment is judged necessary, replaced with a fresh batch.

F Beyond removing dead tissue, secretions collected from the larvae have since been found in laboratory tests to slow the growth of several strains of bacteria commonly found in chronic wounds, including strains resistant to multiple antibiotics, suggesting the treatment's benefit is not limited to the physical clearing of dead material.

G Even where the clinical case for the treatment is strong, some patients refuse it outright, and a number of nurses and doctors have reported their own reluctance to prepare or apply it, so that a treatment shown to work effectively in trials is sometimes not offered simply because of the discomfort it provokes in the people involved in administering it.

Which paragraph contains the following information?

Write the correct letter, A–G, for each statement.

NB You may use any letter more than once.

1. A reference to how the healing effect of larvae was first noticed, before it was studied formally.
2. An explanation of why the treatment was largely abandoned for several decades.
3. A reason given for hospitals returning to a treatment that had previously gone out of use.
4. An explanation of how the larvae are able to clear dead tissue while leaving healthy tissue undamaged.
5. A description of the physical method used to keep larvae in contact with a wound.
6. An additional way in which larvae may help fight infection, beyond removing dead tissue.
7. An obstacle to the wider use of the treatment that has nothing to do with its clinical effectiveness.