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Slightly later than anticipated here are some photos of the Love a Maggot event at the Swansea Science Festival at the end of October 2019.  The LAM team had a great time getting festival goers up to speed on the great work medicinal maggots do, and the maggot racing was a huge hit with everyone!

 

 

In July Prof Mark Reed  (of Newcastle University and Fast Track impact) interviewed Yamni on all things maggots. We had a fabulous time chatting with Mark and bringing him up to speed on the team’s work with schools, festivals and of course the star appearances on Casualty.  You can listen to the podcast here https://www.fasttrackimpact.com/podcast/episode/54030e34/evidencing-impact-from-media-engagement-part-2– enjoy!

Today marked the final episode the Love a Maggot Team worked on with the Casualty team. In this episode a patient with a serious burn is treated by maggot therapy.  Maggot therapy is excellent for cleaning burn wounds, which help the wound to heal faster.  In Magdalena’s case, her wound was on the base of her foot, which might present a challenge to bagged maggots, but Jade and Dylan got around this issue by using  free range maggots directly on the wound and covered with a breathable bandage.

Unfortunately, there was an important issue with Magdalena standing on the maggots!! These tiny little creatures, if placed on the soles of foot wounds can die if squished by the patient forgetting they are there!!

Hopefully, this does not happen too often in real life, and in general maggots can usually work away at their task for 3-4 days before being removed.  If needed though, maggots can be applied over again (depending on the wound) so a course of MDT could last up to several weeks.

Excitingly, a brand new project around maggot therapy in conflict zones has been initiated.  Funded by the Humanitarian Grand Challenge fund ‘Creating Hope in Conflict’, the idea is to provide DIY maggot laboratories to areas in conflict and to develop a set of processes around the rearing and applying of maggots which could help people on the ground to deal with wounds that would otherwise be left untreated.  You can read more about this in our previous blog.   For now, check out the two short videos below where Yamni and Tom talk  and ‘practice’ maggot therapy!

 

In January several news outlets reported on a new research project, partly funded by the UK, which aims to do some exciting work around maggot therapy in conflict zones.  Given we are ‘all in’ when it comes to maggot therapy, we thought we’d catch up with the  project’s lead investigator to see how it is going.

But first, what is the project about?  Conflict zones  are difficult for aid and medical agencies to get to because of interrupted and destroyed infrastructure and insecurity. Consequently, the civilian population is often isolated from outside help. What makes matters worse, is the worrisome trend of fighting parties to attack healthcare facilities. Without access to good surgical care and effective antibiotics, wounds get infected and this can lead to chronic wound infection, necrosis and ultimately amputations, or even loss of life.

Maggot therapy has been shown to remove dead tissue, assist in the control of infection and can promote wound healing through the regeneration of granulation tissue. The best thing though is that maggot therapy is low tech and does not require advanced nursing training. All this makes maggot therapy ideally suited for the use in austere compromised healthcare settings where hygiene is difficult to maintain and surgeons are rare.

Dr Frank Stadler and his team at Griffith University in Australia have been awarded a CAD250,000 grant from Creating Hope in Conflict: A Humanitarian Grand Challenge. The funding for this program has been provided by DFID, USAID and the Dutch Government. The project is working on developing  a shipping container laboratory for the production of high quality medicinal maggots in conflict zones and other compromised healthcare settings, with a capacity to produce medicinal maggots for about 250-300 wounds per day.  In addition, they are developing ‘Do-It-Yourself’ laboratory solutions for conflict-affected isolated communities to establish and run themselves with local resources.  In order to make sure that users of both solutions produce safe medicinal maggots, the team supports training and implementation with richly illustrated multilingual information material and videos.

 

 Frank says “It is early days still. Sorting out the funding agreement and human ethics approval for some aspects of the work takes time. But we are terribly excited to make a start now with the container conversion and preparatory research for the development of DIY labs. We are also looking for research participants we can interview to get a better understanding of the conditions in conflict zone communities and the resources that these people have to establish and run a DIY medicinal maggot laboratory. ”

Frank is keen to hear from anyone who has lived in, or worked with, conflict-affected communities. More information about the interview research is available at https://tinyurl.com/y32ewvvw and anyone interested can also contact Frank Stadler directly via email (f.stadler@griffith.edu.au).

 

Another aspect that Frank’s team needs to take into consideration is the ‘Yuck’ factor which the Love a Maggot team has been looking at.  “We have received great feedback from the grant assessment panel suggesting that conflict-affected communities are likely to embrace maggot therapy. Nevertheless, we are very conscious that maggot therapy is not everyone’s cup of tea and will be working hard to develop culturally appropriate multilingual information material for patients and their families. It is even more important that the healthcare professionals and administrators at humanitarian NGOs, in Ministries of Health, and on the ground are on board and embrace maggot therapy. This is a much harder task but we believe that it can be achieved.”

The Humanitarian Grand Challenge project is funded for two years and will conclude in early 2021. We can’t wait to see what Frank and his colleagues come up with.   We will catch up with Frank to see how the project is progressing later in the year so stay tuned!

 

This blog was written in consultation with Dr Frank Stadler.

It’s always nice to receive a present, and on Casualty tonight Jade and Dylan are given key-rings featuring embedded maggots by a grateful Campbell, who we last saw getting maggot therapy for a pressure ulcer.  The Love a Maggot team approve of maggot related key-rings – though we think our maggot key-ring may edge out Campbell’s in the cuddly stakes.

While it was a lovely thought by Campbell to thank his medical team for using maggots to cure his ulcer,  the thought that is on most clinicians and researchers minds who are working on wound care is how to combat antibiotic resistance.  As Yamni mentions in the video below, bacteria evolve quickly and can become resistant to antibiotics that modern medicine depends on.  The search is on for new classes of antibiotics to combat drug resistant infection but this will take time.  On the other hand, medicinal maggots are adaptive and secrete antibacterial and antifungal molecules that can combat new strains of bacteria and fungus as they encounter them.

Tom Hewes and Yamni discuss the bacteria slaying factories that are medicinal maggots in the below video!  (Thanks to the BBC for filming this video and hat-tip to the Borg!)

This Saturday our favourite medicinal maggot wonders were back in action on Casualty. One of the plots focused around the treatment of pressure sore on the back of a patient.  Maggot therapy (MT) is an excellent treatment for pressure wounds, and indeed wounds such as diabetic foot ulcers and burns.  At first though, the patient doesn’t want to go through with the therapy as he finds the idea of maggots within his wound off-putting (to put it mildly!).  This is not an uncommon reaction for people when first faced with the idea of maggot therapy – we call it the Yuck factor and for the past few years have been researching how people feel about maggot therapy.

In general, when first asked about MT people generally do not want to have it at all, and are worried about what will happen when the maggots are put on the wound and if it will hurt.  However once the procedure is explained and how maggots can help clean certain wounds much faster than other treatments, people tend to be more accepting of the treatment and willing to try it.  You can see that happening in this episode when Jade explains to Campbell how maggots are like hoovers that suck up the bacteria and dead skin in his wound.  Medicinal maggots don’t have teeth, they secrete a digestive juice that breaks down the necrotic part of the wound and then they ‘suck’ the infected dead flesh back in and metabolise it.

Maggots have also been shown to produce antimicrobial factors in their secretions, so can work to kill bacteria that surrounds them in a wound too.  In this episode Jade and Dylan are using free range maggots on their patient, but ‘bagged’ maggots are also used on NHS prescription. In the episode you can see the hospital’s maggot rearing lab – some hospitals around the world do raise their own maggots, but hospitals can also order maggots from companies who specialise in the rearing and distribution of clinical grade medicinal maggots.

Excitingly, Yamni was able to chat with Will and Gabriella (who play Dylan and Jade) about working with maggots on set  – sit back and press play to reveal all!

Yamni and the Love a Maggot team were invited to Oriel Science’s Super Science Sunday in the Waterfront Museum on March 10th.  Our awesome mascot, Matty the Maggot (aka Paul Matthews, the creator of Matty) made his first appearance in person ever! James, Mike, Liam and Leanne were all on hand show off Matty’s friends and Yamni was booked to give a sell-out talk on “Maggots – medical marvels!”  Some photos below of the day!

Before you go and play our game (it’s right there under the Maggots  vs Bacteria  tab!) it might be interesting to see how this game came to be and how long a project like this takes to develop.  In early 2015 Yamni was talking to her colleague Prof Amy Brown about different ways to get the message out about how great medicinal maggots were at zapping bacteria in wounds.  They hit on the idea of some sort of game but at the time didn’t know how to go about starting the process.  A year later, Yamni mentioned the idea of a game to the people at Cherish DE and they suggested that she go have a chat to Dr Sean Walton, a computer scientist based in the Bay campus at Swansea and who also is a game developer.  Yamni and Sean specced out the idea of the game but soon realised they also could do with the advice of a graphic designer and UX specialist.  Luckily Chris Sherwood, a senior UX designer working at Swansea university was interested.  Together they applied for funding from the Impact Acceleration Account at Swansea University and won seed funding to develop the game.  Through 2017 and 2018 the game developed with funding from Cherish DE and when Stephen Mitchell, a software developer and tutor in Swansea joined in 2018 the team was complete and the game came on in leaps and bounds.  The final game was completed in 2019 and was user tested by 200 9-11 year olds in January 2019 before being beta released. The team will be releasing new versions of the game throughout the year taking into account feedback from player.

So please do take the survey when you play the game  – your suggestions might make it into the next release!

Early version of the game!