Survey of patients of the Tver region of Russia regarding maggots and maggot therapy

Abstract

The 21st century is seeing a resurgence in the use of maggot therapy—using the physical and biochemical benefits of fly larvae to debride and heal chronic, problematic wounds. Maggots are repulsive to many people, and this could interfere with the acceptance of this modality. Before instituting a maggot therapy programme at our institution, we sought to better understand the psychological barriers that may exist among patients in the Tver region of Russia. Between 2014 and 2016, all patients with arterial insufficiency and trophic ulcers at City Clinical Hospital No. 7 in Tver were administered a survey consisting of six images. Subjects were asked to rank the images in the order of least to most repulsive or disgusting. A total of 576 subjects were recruited for this study: 414 (72%) women and 162 (28%) men. Nearly 60% of subjects considered the images of maggots to be more repulsive than images of gangrenous wounds. This finding is significant because it indicates that much education and support will need to be conducted to address patient fears and anxiety if patients are to be comfortable with a maggot therapy programme.

Perception and Readiness to Undertake Maggot Debridement Therapy with the Use of Lucilia sericata Larvae in the Group of Nurses

“…However, due to a definitely lower percentage of men compared with women participating in our study, this observation requires a broader and deeper analysis. This seems to be consistent with the results described by Morozov and Sherman [ 9 ], where women (in this case, patients) more often had a strong sense of disgust and rejection at the sight of a photo of a wound with foraging larvae. The reasons for this situation can be found in the cultural education of women and men, the experience of contact with worms in everyday life, the sense of sensitivity and aesthetics that are identified with the female gender.…”

“…The nurses’ readiness for MDT was assessed on the basis of the tools developed by the authors related to the assessment of the perception of the use of MDT (MDT 10). Mrozov and Sherman [ 9 ] confirmed the occurrence of negative emotional reactions in patients with chronic wounds before starting MDT, which indicated negative emotional reactions in patients with chronic wounds before starting MDT. The subjects were primarily afraid and disgusted at the thought of larvae.…”

“…The renaissance of this centuries-old method is attributed to the increasing incidence of chronic wounds infected with multi-drug-resistant organisms (MDROs). Along with the return of MDT, disgust resulting from the negative psychological perception of larvae is also observed, which may hinder the acceptance of this method by medical personnel and the patients with chronic wounds [ 8 , 9 , 10 , 11 ]. The observations and studies by Sherman and Pechter regarding the elimination of bacterial flora, including MRSA (methicillin-resistant Staphylococcus aureus ), by larvae placed in the wound opened new opportunities for researchers and clinicians worldwide [ 6 , 8 ].…”

Perceived stress and readiness to undertake biodebridement in the group of nurses undertaking prevention and treatment of chronic wounds

“…These variables may result in reluctance as well as some concerns about MDT implementation. Morozow and Sherman ( 27 ) drew attention to the perception of patients who declared that the images of maggots were more repulsive than the images of gangrenous wounds. This observation is significant as it indicates that much education and support needs to be put in place to address the concerns and worries of eligible patients.…”

Maggots on BBC Casualty: Evaluating the impact of a Television storyline on awareness and public perceptions of Maggot Therapy

“…Interestingly, for pre-wave participants, despite awareness of Maggot Therapy being higher than other treatments, acceptability of the treatment was significantly lower than it was for all other treatments. It has been reported by many authors, that maggots are not regarded as particularly appealing for therapeutic use [24][25][26]. Indeed, for some individuals the very word "maggot" can entice immediate negative connotations, such as images of rot and decay [27].…”