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Exclusive: Nurses asked for views on use of maggots in wound care

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A biomedical researcher has launched a survey with Nursing Times to find out whether a “Yuck! factor” is deterring nurses from using maggots in wound care.

Yamni Nigam, associate professor at the College of Human and Health Sciences at Swansea University, said she was seeking the honest opinions of both general and specialist nurses as to whether they would be willing to work with maggots or not.

“We are looking for nurses to be completely honest in their responses”

Yamni Nigam

She said: “The survey is trying to find out what nurses know and what they think about maggot therapy. It has been on prescription since 2004 and we have loads of evidence that it works, but the problem is there is this ‘Yuck! factor’ or factor of disgust.”

The survey of nurses is part of a wider study looking at barriers to use for maggot therapy in wound care, which has also included a survey of the general public.

This found just 30% of those surveyed would agree to the use of maggots if they had a wound and were advised maggot therapy would help.

More were willing to try maggot therapy if the wound got worse and they were in pain. Astonishingly, some said they would rather have an amputation than give maggots a go.

“We asked people how they would feel about maggot therapy if they were in pain. As it went up the scale and got more painful, people agreed they would probably try maggots out,” said Dr Nigam.

She suggested that responses might be different among people who were unwell with serious, ongoing wounds.

“Patients with long-standing chronic wounds would probably be more willing to try anything when they get to that point,” she said. “Although there are patients I have spoken to, who said ‘they offered me maggots and I said no’.”

Dr Nigam, who leads the Swansea Maggot Research Group and launched the “Love a Maggot!” campaign last year, said she was keen to find out if some of the same fears and opinions existed among nurses.

“The ‘yuck’ factor is clearly present in the public and we believe, through anecdotal evidence, it may also be present among wound clinicians and in particular nurses, who we know lead wound care in the UK,” she said.

“It’s their remit to decide what particular wound dressing or intervention they would put on a particular wound – usually district, community and tissue viability nurses make that decision.”

While there are several teams researching the potential benefits of maggots in Europe and the US, Dr Nigam admitted the field was not exactly “fashionable”.

She said she was keen to get as many nurses as possible to fill in the survey and hoped Nursing Times readers would help share it among nursing colleagues and friends.

“We are looking for nurses to be completely honest in their responses, so we can better understand the current use cases for maggot therapy,” she said.

Dr Nigam, who has worked with leading nurses in the field of maggot therapy, said she wanted to gather the views of general nurses as well as those specialising in wound care.

She noted: “As part of the survey, we have asked nurses for their speciality, so we get an idea of the general understanding of maggot therapy in different areas of nursing.”

Findings from the survey will form part of a paper due to be published in the new year. The deadline for responses is four weeks from today, which also happens to by Christmas Day.

What is maggot debridement therapy?

Maggot debridement therapy (MDT) is an accepted, effective method of treating chronic (non-healing) wounds with live, germ-free fly larvae (maggots). It is also sometimes called larval therapy, biodebridement, or simply maggot therapy. In maggot therapy, disinfected (germ-free) fly larvae are applied to wounds for three to four days within special dressings that prevent the maggots from escaping the wound. Medicinal maggots are used in human and veterinary wound care for debriding non-healing necrotic skin and soft tissue wounds, including: pressure ulcers; venous stasis ulcers; neuropathic foot ulcers; non-healing post-surgical wounds; non-healing traumatic wounds. Maggots disinfect the wound and speed the rate of healing.

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Readers' comments (5)

  • I've seen maggots used in practice, on a patient with a chronic breast wound. They were fantastic! They sped up healing considerably and without them I was told this wound was unlikely to heal. The patient was a wonderful calm lady who dealt very well with the fact she was essentially putting maggots in her bra! I don't know if I would be quite as brave....however, the maggots were in a sort of teabag looking dressing, initially you couldn't actually tell they were maggots. It was only when they fattened up after a few days they appeared maggot-like!! And they would remain encased inside the 'teabag'.

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  • Wow! That’s amazing! I personally would use green clay on myself rather than maggots! Green clay is a powerful wound healer too, it sucks up all the crap out of a wound and adds its minerals to it at the same time, therefore promoting tissue healing, it also minimises scaring! And it’s so easy to use and clean!

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  • I recall (many years ago!) using leeches on a woman with an intractable and huge haematoma. Worked like a dream but the poor leeches met sticky end! I can't see anything wrong with using evidence based practice involving maggots, provided the patient is amenable.

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  • I have to say that I find the idea somewhat repellent. However, as I always say in relation to almost any seemingly intractable problem, "when things get bad enough, the solution will become apparent." If it came to a choice between certainly losing a limb or having a fighting chance of keeping it, I would suppress my conditioned attitude and go for it. Ultimately, rationality has to win out. Eventually this may become culturally accepted and part of conventional medical practice.

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  • There is a large number of other "yucky" treatments: swine valves, bovine insulin, mice ovarian inhalers, flexiseal etc. What's wrong with the wound biodebridement? Perhaps if the person with chronic ulcer had to pay for the dressings, they would eagerly go for the most efficient solution?

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