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Maggots can efficiently do what antibiotics sometimes can’t

Bio tea bag

You may know that maggots are very efficient at cleaning up wounds and repairing them as the feed on dead tissue. There’s been a slight resurgence in their use in NHS hospitals in the UK. They were first used during the First World War when surgeons realised that soldiers’ wounds that were maggot infested healed faster than those that weren’t.

Bio tea bag

Bio tea bag. Image in public domain

Prof Yamni Nigam, an entomologist at Swansea University, has explained the beauty of greenbottle fly maggots which are grown specially for the NHS by a business based in Bridgend, Wales called BioMonde. They breed flies for egg collection. The maggots are sealed in ‘teabags’ called ‘biobags’ which are delivered to hospitals and health centres.

Nigam told the Today programme on Radio 4: “Maggots are so efficient and cost-effective. they can turn a stagnant wound that has been refusing to heal for months – within four days they can transform the wound. One of the key things that maggots can do is disinfect the wound. If you’ve got a chronically infected wound, putting maggots [will clear the dead tissue]. Then they drink all that slurry through the bag, and you remove the bag.”

There is a yuck factor which is a barrier to using maggots as an alternative to treating wounds with antibiotics which can sometimes be ineffective. Maggots secrete anti micro-biomolecules to kill bacteria and release enzymes that soften the dead tissue into a liquid which they can drink. The maggot teabags are removed from the wound after four days and before they start developing into flies.

Maggots were used before antibiotics were developed. Antibiotics sometimes don’t work because of overuse. This is one of the great fears of general practitioners and physicians. They believe that overuse of antibiotics nullifies their effectiveness as bacteria adjust. It is why, in the UK, general practitioners are reluctant to prescribe antibiotics nowadays.

But the use of maggots stopped when antibiotics became the default method of dealing with bacterial infections. There is a minor resurgence in maggot therapy to treat wounds as they use increased from 886 in 2008/2009 to 1305 in 2018/2019.

To return to the yuck factor, Nigam said: “Nurses that are specialists in wound care tend to have seen maggot therapy and are on board with the idea of using it. Whereas non-specialist wound nurses and general staff nurses don’t really want to use maggots. Then we have this issue where staff nurses are reluctant to join in. Certainly, everybody has a natural aversion to creepy crawlers and most people tend to have an inherent disgust as far as maggots are concerned.”

She said that the yuck factor among nurses could be overcome through further training.

There’s a good specific example of the use of maggots. It’s on the Spaulding High website. I believe this is a school website. A 48-year-old patient, Linda Wegemann is a diabetic (I presume that she is still alive). As is usual with diabetics she suffered from neuropathy in her feet. The nerves had died which leads to ulcers and she feared that her legs would be amputated. Thanks to maggots, her legs were saved as I understand it. The chairman of another company producing biobags, the Biomantis Corporation, said “Thanks to this method, 50% of future amputations due to infection can be prevented”.

Do flies feel pain? Yes, but in what way?

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