Maggot therapy for the world

Maggot therapy is the application of living fly larvae to wounds that don’t heal, contain dead tissue, or are infected. Applied to the wound, maggots perform three important therapeutic functions:

  • remove dead tissue,
  • control infection, and
  • promote wound healing

Maggot therapy is the only wound care therapy that provides all three of these therapeutic benefits in one low-tech treatment. Moreover, maggot therapy is affordable to patients in high- and low-resource healthcare settings alike. It can provide limb- and life-saving care in times of conflict, disaster, and in poverty where there are few healthcare workers and insufficient wound care supplies.

We want to give every patient access to maggot therapy no matter where. To do this we deliver the necessary supply chain innovations that ensure the production of high-quality medicinal maggots, their timely transport to the point of care, and the training for healthcare providers, even in the most compromised healthcare settings.

Creating Hope In Conflict

Problem: Even though we live in unprecedentedly peaceful times, there are still many conflicts and wars raging around the world. In these conflicts the civilian population must bear the brunt of destruction, death, and injury. With weak economies, broken infrastructure, and dysfunctional healthcare systems, there are not enough resources to care for the injured. Without effective antibiotics and surgical expertise, war wounds become chronically infected and many limbs must be amputated to prevent patients dying from sepsis.

Solution

Solution: With generous support from Hope in Conflict: A Humanitarian Grand Challenge, we were able to develop maggot therapy supply chain solutions that enable isolated communities to establish and maintain maggot therapy production laboratories with local resources. We have also developed highly visual and multi-lingual training resources explaining maggot therapy and the clinical indications and contraindications for the treatment.

Disaster Medical Aid

Problem: Disasters are a constant threat in many parts of the world, whether it be earthquakes, tsunamis, storms, wildfires, or technological disasters such as petrochemical fires and explosions. Invariably, many more people get injured than killed and those that survive often suffer a long time from wounds that become infected and fail to heal.

By their very nature, disasters destroy not only homes but also healthcare infrastructure, and when such disasters happen in already economically depressed low-and middle-income countries caring for many patients at the same time becomes a huge challenge.

Best practice wound care includes antibiotic treatment and surgical debridement prior to reconstruction and/or closure. In austere settings this treatment regimen is challenged, especially in mass casualty events. Available surgical capacity dictates triage decision-making.

Solution: With maggot therapy at their disposal, first responders and aid organisations can treat wounds without requiring surgical expertise which means many more patients can be treated and many more limbs and lives saved. This is because maggot therapy controls and prevents infection and removes dead tissue. Thus, it keeps the patient in good health (given the circumstances) and prepares the wound for grafting or closure.

Low- and Middle-Income Country Wound Care

Problem: Low- and middle-income countries (LMICs) struggle to establish and maintain effective healthcare systems. Even with development support and national health insurance schemes in place, healthcare remains expensive for ordinary citizens. A chronic wound like a diabetic ulcer can burden families with catastrophic healthcare expenditure. What makes matters worse, patients remain incapacitated and not able to contribute to the care and income of their family.

Solution: We have carefully studied the characteristics of actual and theoretical maggot therapy supply chains both in high- and low-resource settings. Our insights and new supply chain solutions allow us to provide LMIC-ready supply chain solutions, from production and distribution of medicinal maggots to clinical decision-making and training.

Rural and Remote Australia

Problem: Australia is a vast country with different socio-economic groups, geographic regions, and healthcare settings. While most Australians live along the coastal fringe and in larger towns and cities, there are rural and remote mining, farming, and Indigenous communities across the country that deserve the same level of care available to patients in larger population centres. Australia also has an ageing population with many Australians suffering from age-related and chronic diseases including diabetes, cardio-vascular disease, cancer and immobility – all result in a high prevalence of wounds. Poor public health and inadequate primary care in rural and remote communities further increase the risk of developing chronic wounds.

Solution: We are developing supply chain solutions to enable timely and cost-effective provision of maggot-assisted wound care in compromised healthcare settings. These innovations have also the capacity to address many of the non-metropolitan wound care challenges across Australia.

Defence

Problem: Shifting international power dynamics and our changing climate are predicted to spark new conflicts. The nature of armed conflict is also changing. For example, the US Army is preparing for theatres of war where the current doctrine of the golden hour no longer applies. Up to now, soldiers could expect to be evacuated within one hour of sustaining an injury. Anticipated future conflicts may no longer permit such rapid response meaning that casualties will have to be cared for on the battlefield or in lower tier field hospitals that are cut off from evacuation routes.

Solution: Our supply chain solutions for disaster and conflict aid are transferable to the defence setting. In addition, customised products for battlefield deployment of maggot therapy are in development.

(C) The content on this page is Copyright (2021) MedMagLabs. (CC) Creative commons content used on this page includes: Banner image by MedMagLabs, CC BY | Earthquake rubble: US Air Force, Flickr, United States government, CC | LMIC nurse in clinic: AMISOM Public Information, Flickr, CC0 1.0 | Wound man: Pseudo-Galen, Anathomia, WMS 290, Wellcome Collection, CC BY 4.0 | Please view the video credits for copyright information pertaining to its content.

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