Maggots are recognised as a highly successful, cost-effective and safe clinical treatment for chronic wounds. But convincing patients and even some medical professionals to let them consume our infected skin so it returns back to health is proving a challenge, says Dr Yamni Nigam, founder of Swansea University Maggot Research Group. According to her recent survey of attitudes towards maggots, just thinking about maggots made 28 per cent of people feel ill.
"The most common association with maggots is disgust, and this 'yuck' factor is preventing us from benefiting from maggots' ability not only to clean and disinfect wounds, but also stimulate wound healing," she points out. In a survey of 412 people, more than a third found maggots disgusting, 40 per cent stated that thinking about maggots made their skin crawl, and over half were worried about the sensation of maggots on their skin. When asked their thoughts about using maggot therapy, close to one in 10 respondents said they would prefer to have a limb amputated than try treatment with maggots.
Nearly four out of 10 people, the survey shows, would opt for a conventional treatment such as dressings rather than maggot therapy. Better education about maggots, Dr Nigam feels, could help people change their minds. Her 'Love a Maggot' campaign, to be showcased at a public event held during the ESRC Festival of Social Science, aims to help people overcome their squeamishness by getting up close to live maggots and learning just how effective they are for treating chronic, stubborn wounds including pressure (bed) sores, diabetic foot ulcers, leg ulcers caused by vascular disease and even severe burns.
"People have a lot of misconceptions," she explains. "But the larvae of Lucilia Sericata (green bottle fly maggots) have been used successfully for centuries to remove infected or dead tissue from a wound, exposing the surrounding healthy tissue and speeding up healing. It has been reported that the surface area of wounds can shrink 22 per cent in size a week when maggots are applied – which is much faster than when conventional dressings are used. In fact, we have seen maggots clean up chronic wounds that have been present in a patient for more than a year in just three days."
In maggot therapy, clean, sterile, baby maggots (one to two millimetres) are applied to a wound for a three-day period in a special sealed bag, allowing them to breathe but not escape. Many people feel either nothing or a tickling sensation. A few do feel pain, possibly due to pressure on the wound, which can be relieved with painkillers. "One commonly expressed fear is that maggots could escape and eat healthy skin or turn into flies, but this really can't happen," says Dr Nigam. Green bottle fly maggots, unlike some other maggot species, do not eat healthy human skin. Nor can they pupate and turn into flies in just three days.
Dr Nigam is keen to convince not only the general public, but medical professionals too. "A possibly surprising finding from our research is that, despite the strong case for maggots, some clinicians (particularly senior medical staff) turn out to be pretty squeamish about them too and are just not that keen on prescribing the treatment," she says. "We aim to explore the reasons for this reluctance in the next phase of our research."
Raising awareness of maggots' amazing powers is important, she feels, as maggots' medical potential may extend beyond simply healing wounds. Dr Nigam’s latest research project has identified a bacteria-killing molecule present in maggots which could, in time, result in a new antibiotic. "This is particularly exciting given increasing global concerns regarding the declining effectiveness of existing antibiotics," she explains.
This research project, which is funded by Welsh Crucible and more will be highlighted at the Festival of Social Science event 'Love a maggot!', on Thursday 10 November, from noon until 5pm at Swansea Central Library, County Hall Building, Swansea.