WEBVTT - Ep 141 Maggots: Such noble work 0:00:00.120 --> 0:00:03.520 At a certain battle during nineteen seventeen, two soldiers with 0:00:03.640 --> 0:00:06.640 compound fractures of the femur and large flesh wounds of 0:00:06.640 --> 0:00:10.280 the abdomen and scrotum were brought into the hospital. For 0:00:10.440 --> 0:00:14.280 seven days, they lay on the battlefield without water, without food, 0:00:14.640 --> 0:00:17.120 and exposed to the weather and all the insects which 0:00:17.160 --> 0:00:20.400 were about that region. On their arrival at the hospital, 0:00:20.480 --> 0:00:22.880 I found that they had no fever, and that there 0:00:22.960 --> 0:00:27.040 was no evidence of septicemia or blood poisoning. Indeed, their 0:00:27.080 --> 0:00:30.320 condition was remarkably good, and if it had not been 0:00:30.360 --> 0:00:32.800 for their starvation and thirst, we would have said they 0:00:32.800 --> 0:00:36.440 were in excellent condition. When I noticed the extent of 0:00:36.440 --> 0:00:38.960 the wounds, I could not but marvel at the good 0:00:39.080 --> 0:00:44.320 constitutional condition of the patients. This unusual fact quickly attracted 0:00:44.320 --> 0:00:47.400 my attention. I could not understand how a man who 0:00:47.400 --> 0:00:49.760 had lain on the ground for seven days with a 0:00:49.760 --> 0:00:53.360 compound fracture of the femur, without food and water should 0:00:53.360 --> 0:00:57.560 be free of fever and evidence of sepsis. On removing 0:00:57.600 --> 0:01:00.480 the clothing from the wounded part, much was my surprised 0:01:00.520 --> 0:01:04.560 to see the wound filled with thousands and thousands of maggots, 0:01:04.840 --> 0:01:09.600 apparently those of the blowfly. These maggots simply swarmed and 0:01:09.680 --> 0:01:11.639 filled the entire wounded area. 0:01:12.160 --> 0:01:13.440 The site was very. 0:01:13.240 --> 0:01:16.760 Disgusting and measures were taken hurriedly to wash out these 0:01:16.840 --> 0:01:20.760 abominable looking creatures. Instead of having a wound filled with 0:01:20.840 --> 0:01:23.920 puss as one would have expected, these wounds were filled 0:01:23.920 --> 0:01:29.919 with the most beautiful pink granulation tissue that one could imagine. 0:01:30.240 --> 0:01:34.000 These patients went on to healing, notwithstanding the fact that 0:01:34.040 --> 0:01:37.839 we removed their friends which had been doing such noble work. 0:02:24.040 --> 0:02:28.679 I love it. I love how munch Aaron. It's such 0:02:28.680 --> 0:02:29.600 a noble work. 0:02:30.520 --> 0:02:32.840 I can it's such a noble work. 0:02:35.120 --> 0:02:41.680 It's I just love maggots, Aaron. This episode has transformed. 0:02:41.960 --> 0:02:44.760 It is something I never thought that I would say ever. 0:02:45.800 --> 0:02:47.800 And I love them so much. 0:02:48.200 --> 0:02:52.560 I love them. They're the best. That first hand account 0:02:52.639 --> 0:02:55.920 was from William bhar from nineteen thirty one in a 0:02:56.000 --> 0:03:00.760 paper titled the Treatment of Chronic Osteomilitis with the Maggot 0:03:00.880 --> 0:03:02.120 Larva of the blowfly. 0:03:02.800 --> 0:03:07.680 Love it those blowfly larva. Hi, I'm Aaron Welsh and 0:03:07.760 --> 0:03:09.560 I'm Aaron aman Updyke and. 0:03:09.600 --> 0:03:11.440 This is this podcast will kill You. 0:03:12.000 --> 0:03:15.560 Welcome to today's episode. It's all about maggots. 0:03:15.960 --> 0:03:20.000 It's going to be so much fun. And what makes 0:03:20.000 --> 0:03:22.360 it even more fun is that this is kind of 0:03:22.400 --> 0:03:27.160 like a two parter. It is, Yeah, it's like companion pieces. 0:03:28.639 --> 0:03:31.240 It was originally intended as a two parter that we 0:03:31.360 --> 0:03:35.960 realized was really two companion pieces because who knew there 0:03:36.040 --> 0:03:39.840 was so much to love about both maggots and next 0:03:39.840 --> 0:03:41.640 week's stars. 0:03:41.840 --> 0:03:46.240 Leeches leeches, I mean, and like, I think the connection 0:03:46.400 --> 0:03:50.839 will become fairly clear as when we get through these. 0:03:50.880 --> 0:03:55.680 But basically, these are two organisms that carry with them 0:03:55.680 --> 0:03:58.800 a certain dick or yuck factor. Major They have been 0:03:58.880 --> 0:04:04.280 used in medicine for centuries, thousands of years even, and 0:04:04.440 --> 0:04:08.840 have kind of recently experienced a resurgence and popularity, and 0:04:08.960 --> 0:04:12.120 I just there are so many amazing things about them. 0:04:12.200 --> 0:04:15.000 So yeah, it's gonna be really fun. 0:04:15.240 --> 0:04:18.400 It's really gonna be a fun episode. Next week's also 0:04:18.440 --> 0:04:21.919 going to be so much fun. I'm thrilled. I just 0:04:22.000 --> 0:04:25.280 I learned so much researching for this, and like, ugh. 0:04:25.560 --> 0:04:31.040 Maggots, maggots who knew a lot of people, A lot of. 0:04:30.960 --> 0:04:33.320 People did and now and now we get to know too. 0:04:35.360 --> 0:04:37.760 But before we get into all of that good stuff 0:04:37.839 --> 0:04:43.560 about maggots, it's quarantine time. Is what are we drinking 0:04:43.600 --> 0:04:44.080 this week? 0:04:44.360 --> 0:04:46.800 We're drinking A Tale of two worms? 0:04:48.480 --> 0:04:48.760 Wait? 0:04:49.440 --> 0:04:52.800 That is oh my gosh, No, that is actually the title. 0:04:53.000 --> 0:04:56.080 That is the title. But I like, I made the 0:04:56.200 --> 0:05:01.600 quarantiney picture and the recipe as the best of both worms. 0:05:01.839 --> 0:05:02.719 No, did you really? 0:05:03.160 --> 0:05:07.719 Yes? I did. Let me pull it up. I sent 0:05:07.839 --> 0:05:09.839 it over to you, Aaron. How did I not even 0:05:09.880 --> 0:05:17.560 notice Aaron, best of both worms? Because that's how it 0:05:17.640 --> 0:05:20.720 was written down in my notebook, and so I was like, 0:05:21.600 --> 0:05:24.279 oh yeah, and it literally did not cross my my 0:05:24.520 --> 0:05:27.400 mem and I obviously I looked at all of your things, 0:05:27.400 --> 0:05:28.520 didn't even read the title. 0:05:28.680 --> 0:05:30.920 Mm hm cool. 0:05:31.880 --> 0:05:35.919 Okay, so we're drinking either. It's gonna be easy to change. 0:05:36.080 --> 0:05:37.840 I think we're drinking A Tale of two worms. 0:05:37.920 --> 0:05:39.920 A Tale of two worms. I love it because we're 0:05:39.920 --> 0:05:44.080 telling tales of these two squirmy worm things asterisk. We 0:05:44.200 --> 0:05:46.520 know that mackets are not worms. We're very well aware. 0:05:47.040 --> 0:05:51.880 Yeah, but a lot so like you know, colloquial spiders 0:05:51.880 --> 0:05:56.719 are bugs, that kind of thing, like we know the difference, 0:05:56.760 --> 0:06:01.560 but forgive us, oh bit. But in best of both worms, 0:06:01.640 --> 0:06:05.200 oh my god, in in a Tale of two worms, 0:06:05.800 --> 0:06:11.000 we have it's basically like fancy fruit punch with vodka 0:06:11.160 --> 0:06:13.159 and Fammi worms delicious. 0:06:13.440 --> 0:06:17.000 We'll post the full recipe for that quarantine as well 0:06:17.040 --> 0:06:19.680 as our non alcoholic Plussy burita on our website. This 0:06:19.720 --> 0:06:21.600 podcast will kill you dot com and on all of 0:06:21.640 --> 0:06:23.320 our social media channels. 0:06:23.640 --> 0:06:27.680 We will. If you're not already following us on our 0:06:27.720 --> 0:06:30.800 social media channels, you really should because we're having on 0:06:30.920 --> 0:06:33.880 some pretty cool content. You know. We've got some reels, 0:06:34.480 --> 0:06:36.360 we got normal posts. 0:06:35.960 --> 0:06:36.920 Normal posts. 0:06:37.000 --> 0:06:41.159 We we're on TikTok even, we're on TikTok even finally 0:06:41.200 --> 0:06:44.560 getting with the program right before it probably will be banned, 0:06:44.640 --> 0:06:48.480 but yep, you know, and check us out there. Also 0:06:48.640 --> 0:06:51.760 our website. Let's shout out our website, as we usually do. 0:06:52.279 --> 0:06:55.360 It's got some good stuff. It's got transcripts, it's got 0:06:55.360 --> 0:06:58.520 our bookshop dot org affiliate account, it's got our Goodreads list, 0:06:58.800 --> 0:07:01.520 it's got all this. Verses for all of our episodes. 0:07:01.560 --> 0:07:04.799 Links to merch links to music by Bloodmobile, links to Patreon, 0:07:05.279 --> 0:07:07.720 links to a form where you can submit your first 0:07:07.720 --> 0:07:10.600 hand account, which is plasome. We get so many incredible 0:07:10.640 --> 0:07:13.920 people who share their stories with us that we cannot 0:07:13.920 --> 0:07:17.480 think enough, and so if you're interested in sharing a 0:07:17.760 --> 0:07:21.880 story or have a request for a particular topic, please 0:07:21.920 --> 0:07:22.920 reach out to us. 0:07:23.400 --> 0:07:28.360 Well with that, shall we get into this episode all 0:07:28.360 --> 0:07:29.400 about maggots. 0:07:29.680 --> 0:07:32.240 Let's do it right after this break. 0:08:05.600 --> 0:08:08.440 I have to start out just by giving a huge 0:08:08.760 --> 0:08:11.720 shout out to the pretty much only source that I 0:08:11.840 --> 0:08:15.920 used for this biology section of maggots, which was a paper, 0:08:16.040 --> 0:08:18.640 except I think it's more like a book, a compendium, 0:08:19.200 --> 0:08:24.640 a book called The Complete Guide to Maggot Therapy, Clinical Practice, 0:08:24.680 --> 0:08:27.760 therapeutic Principles, production, distribution, and ethics. 0:08:27.840 --> 0:08:29.520 When they say complete. 0:08:29.520 --> 0:08:32.000 That is as complete as it gets. 0:08:32.480 --> 0:08:35.800 It was such a gem to read. I love it 0:08:35.880 --> 0:08:37.720 so much, and I loved it so much that I 0:08:37.760 --> 0:08:42.079 actually want to start off with a beautiful line from. 0:08:41.920 --> 0:08:44.199 The introduction chapter. Are you ready for this? 0:08:44.559 --> 0:08:45.040 I think so. 0:08:45.280 --> 0:08:45.760 Quote. 0:08:46.520 --> 0:08:50.880 The human body is fragile, and therefore wounds acute and 0:08:51.000 --> 0:08:54.440 chronic have always been part of the human condition since 0:08:54.559 --> 0:09:00.720 time immemorial. Likewise, flies have evolved to exploit during development 0:09:01.040 --> 0:09:06.000 the ephemeral cadavers and wounds of living animals. Humans included 0:09:07.160 --> 0:09:08.680 ephemeral cadavers. 0:09:10.040 --> 0:09:10.559 Beautiful. 0:09:10.559 --> 0:09:13.120 Loved it so flowery. I don't get to read things 0:09:13.160 --> 0:09:17.040 like that very often this podcast. So I want to 0:09:17.040 --> 0:09:20.720 start off, I mean I already started off, but let's first. 0:09:21.040 --> 0:09:24.520 I want to talk about chronic wounds because they're a 0:09:24.520 --> 0:09:26.320 really important part of the Maggot story. 0:09:27.360 --> 0:09:28.400 Chronic wounds. 0:09:28.440 --> 0:09:31.120 The idea of a chronic wound is simply a wound 0:09:31.200 --> 0:09:36.120 that doesn't heal along a typical trajectory, and so you 0:09:36.240 --> 0:09:39.959 see this a lot in medicine, and there's not necessarily 0:09:40.160 --> 0:09:43.280 one specific timeframe on like when you would consider a 0:09:43.320 --> 0:09:47.280 wound chronic versus acute or something like that. But generally, 0:09:47.760 --> 0:09:51.760 chronic wounds can be present for months to years, and 0:09:51.840 --> 0:09:54.720 if something isn't done, some kind of wound care to 0:09:54.920 --> 0:09:58.760 help chronic wounds heal, they can persist for years or 0:09:58.880 --> 0:10:05.400 decades and be very debilitating physically, mentally, emotionally. They can 0:10:05.520 --> 0:10:08.600 lead to a lot of complications down the line. So 0:10:08.640 --> 0:10:13.840 why chronic wounds? Why are these important? Chronic wounds often 0:10:13.920 --> 0:10:18.000 have a significant amount of necrotic or dead tissue that 0:10:18.120 --> 0:10:21.760 covers them, and in order for them to heal, part 0:10:21.800 --> 0:10:23.800 of the wound care process is that they have to 0:10:23.840 --> 0:10:27.000 be debrided, meaning that the necrotic tissue has to be 0:10:27.080 --> 0:10:30.920 removed all the way down to a layer of more 0:10:31.040 --> 0:10:35.400 well vascularized like healthy bleeding tissue what was described in 0:10:35.440 --> 0:10:39.720 the first hand account as that granulation tissue. That granulation 0:10:39.800 --> 0:10:43.960 tissue is our bodies healing from the bottom up, which 0:10:44.000 --> 0:10:49.400 is actually how wounds heal. So how can we accomplish 0:10:49.400 --> 0:10:54.360 this process, like what does wound care entail? That is 0:10:54.400 --> 0:11:00.680 where we can enter maggots sometimes, So maggot for anyone 0:11:00.679 --> 0:11:05.520 who is uninitiated, is a colloquial term for the larvae 0:11:05.679 --> 0:11:12.640 of flies flies large group obviously Holometabolis insects, so their 0:11:12.880 --> 0:11:16.480 larva look nothing like the adult they have to pupate, 0:11:16.520 --> 0:11:20.240 they rearrange their whole body. Caterpillars are butterfly larva, grubs, 0:11:20.280 --> 0:11:25.720 beetle larva, maggots, fly larva. But flies are a huge, huge, 0:11:25.800 --> 0:11:31.080 huge order of insects that includes mosquitoes, houseflies, horseflies. So 0:11:31.160 --> 0:11:34.280 when we say maggots, which is not like a scientific term, 0:11:34.280 --> 0:11:38.120 it's very much a colloquial term. We kind of specifically 0:11:38.480 --> 0:11:43.400 use that for the larva of flies that you probably 0:11:43.520 --> 0:11:45.600 think of when you think of the word fly. Does 0:11:45.600 --> 0:11:49.360 that make sense, Yeah, Okay, Like it's it's still a 0:11:49.400 --> 0:11:51.880 pretty general term, but it's like most of the flies 0:11:51.880 --> 0:11:53.320 that you look at it and you're like, that's a fly, 0:11:53.880 --> 0:11:54.640 they're larva. 0:11:54.760 --> 0:11:55.480 Are maggots. 0:11:56.600 --> 0:12:01.160 Okay, So the flies that we talk about in medicine, 0:12:01.200 --> 0:12:08.280 medicinal maggots generally are from the specific species Lucilla seracatta. 0:12:09.200 --> 0:12:12.120 I think is how you pronounce it. I tried really 0:12:12.160 --> 0:12:14.520 hard to look it up. But this is the common 0:12:14.640 --> 0:12:19.720 green bottlefly, and one other species Lucillia couprina, which is 0:12:19.720 --> 0:12:24.880 the Australian sheep blowfly. So both of these are blowfly species. 0:12:25.160 --> 0:12:28.120 They're actually kind of pretty. They're green. They're really shiny 0:12:28.160 --> 0:12:32.880 and metallic, and again they look like a fly, just green. 0:12:34.040 --> 0:12:36.120 Okay, I'm with the maggots. 0:12:36.160 --> 0:12:37.320 You're with me, Thank you. Good. 0:12:38.920 --> 0:12:41.960 The maggots themselves, if anyone hasn't had the pleasure of 0:12:41.960 --> 0:12:45.840 seeing maggots look like little wiggly grains of rice. Especially 0:12:45.920 --> 0:12:48.600 when they're in their first in star. They're pretty small 0:12:49.360 --> 0:12:51.600 and they just sort of wiggle around, and then as 0:12:51.600 --> 0:12:53.600 they molt through their various in stars, they get a 0:12:53.600 --> 0:12:55.760 little bit larger, and then you can tell that they 0:12:55.800 --> 0:12:59.720 have little segments on their bodies and they breathe through 0:13:00.000 --> 0:13:04.079 spiracles on their butts, so they bury their heads into 0:13:04.640 --> 0:13:09.160 wounds or decaying flesh, and they stick their butts out 0:13:09.200 --> 0:13:13.080 in order to breathe. So, when it comes to the 0:13:13.200 --> 0:13:15.520 use of maggots in medicine, and the reason that I 0:13:15.520 --> 0:13:18.360 talked about chronic wounds at the top is that the 0:13:18.480 --> 0:13:22.480 primary use of maggots is in the treatment of chronic wounds. 0:13:22.840 --> 0:13:26.000 Sometimes maggots can be used for other wounds or acute 0:13:26.040 --> 0:13:30.360 things like burns, but mostly they're used for chronic wounds. 0:13:30.720 --> 0:13:34.920 And in this capacity they have three incredible functions that 0:13:35.000 --> 0:13:38.680 I will get into in detail. First, they can help 0:13:38.760 --> 0:13:42.880 to remove that dead or necrotic tissue that prevents chronic 0:13:42.920 --> 0:13:47.280 wounds from healing. Two is that they help to control infection, 0:13:47.480 --> 0:13:51.080 which is a huge issue in chronic wounds. And three 0:13:51.200 --> 0:13:53.920 they actually promote wound healing. 0:13:54.960 --> 0:13:55.760 They're really cool. 0:13:56.920 --> 0:13:59.160 So how do they do all of these three amazing things? 0:13:59.200 --> 0:14:02.440 Like they are worm babies, Well, how do they do this? 0:14:04.240 --> 0:14:09.840 Blowfly larva. Maggots in the wild eat dead animal tissue. 0:14:10.000 --> 0:14:11.440 That is what they do, that is what they have 0:14:11.480 --> 0:14:14.920 evolved to do. So they will happily eat the necrotic 0:14:15.080 --> 0:14:18.480 or dead tissue on a wound like that part makes sense. 0:14:18.520 --> 0:14:20.920 They will eat dead tissue, any dead tissue that they 0:14:20.960 --> 0:14:24.600 can find. But there are a few things about these blowflies, 0:14:24.680 --> 0:14:27.880 especially the ones that we use in medicine, that make 0:14:27.960 --> 0:14:34.920 them especially good at wound debreaedment. First, maggots don't have 0:14:34.960 --> 0:14:37.920 any real mouthparts, so they can't bite you, they can't 0:14:37.960 --> 0:14:42.800 crush your flesh, they don't pierce you. Instead, they rely 0:14:43.000 --> 0:14:46.280 on what's called extra corporeal digestion. 0:14:47.640 --> 0:14:49.040 It's one of my new favorite. 0:14:48.680 --> 0:14:55.160 Phrases, yeah, meaning that they are secreting a whole bunch 0:14:55.280 --> 0:15:00.200 of digestive enzymes and antimicrobial substances. They're spinning it out out, 0:15:00.520 --> 0:15:04.400 they're letting that flow over their food, which, if it's 0:15:04.440 --> 0:15:07.720 a chronic wound, is your wound. And then they have 0:15:07.840 --> 0:15:11.080 these two little mouth hooks that they use to kind 0:15:11.080 --> 0:15:13.920 of separate out their food bits. And they also use 0:15:13.960 --> 0:15:16.840 these hooks to crawl their little bodies around. That's how 0:15:16.840 --> 0:15:21.520 they crawl around, and this helps to those digestive enzymes 0:15:21.520 --> 0:15:25.440 that they've secreted out to penetrate deeper into the surface 0:15:25.480 --> 0:15:29.120 of the tissue that they're digesting. And then they suck 0:15:29.200 --> 0:15:31.800 up that juice and that's what they eat, which allows 0:15:31.880 --> 0:15:36.560 them to grow. Also, this way of feeding this extra corpse. 0:15:36.560 --> 0:15:39.000 I'm so excited I can't pause for a question yet. 0:15:39.960 --> 0:15:43.280 But this way of feeding helps their neighbors as well, 0:15:43.320 --> 0:15:46.560 because all of the maggots in a group will combine resources, 0:15:46.600 --> 0:15:50.520 combine all of those digestive enzymes, which increases the efficiency 0:15:50.920 --> 0:15:52.320 in large populations. 0:15:52.680 --> 0:15:57.520 Okay, I have so many thoughts. That is amazing. I 0:15:57.600 --> 0:16:00.760 assume at a certain point our resources limit to when 0:16:01.000 --> 0:16:03.280 then it's like not helpful if they run out of 0:16:03.720 --> 0:16:06.800 tissue or whatever to eat. Yes, okay, so. 0:16:07.440 --> 0:16:14.760 Yeah, so they are very efficient at just finding that 0:16:14.880 --> 0:16:17.680 necrotic tissue for the most part. And we'll get into 0:16:17.720 --> 0:16:22.840 like there could be complications, but yes, they are going 0:16:22.880 --> 0:16:25.640 to find like the most necrotic tissue and that is 0:16:25.680 --> 0:16:28.440 what they are going to specialize on for the most part. 0:16:29.080 --> 0:16:31.920 And then when they're done, they're going to leave. They're 0:16:31.920 --> 0:16:36.680 going to go someplace new. Right, So, on a chronic 0:16:36.760 --> 0:16:40.880 wound that's full of dead tissue, they are secreting these 0:16:41.000 --> 0:16:44.840 enzymes that are literally digesting it, which is a form 0:16:44.920 --> 0:16:47.880 of chemical debreedment. Right, So that's the first way that 0:16:47.880 --> 0:16:50.800 they're debrading it. But on top of that, their little 0:16:50.880 --> 0:16:54.320 mouth hooks are also helping to break up that dead tissue, 0:16:54.360 --> 0:17:00.480 so they're also doing physical debreedment, and not passive the 0:17:00.520 --> 0:17:04.760 way that like a piece of gauze with bleach sits 0:17:04.800 --> 0:17:07.639 on the surface and does a chemical debridement, and then 0:17:07.640 --> 0:17:09.879 when you pull that gauze off, it's going to have 0:17:10.000 --> 0:17:14.200 some kind of physical debreatment. But these are active, live 0:17:14.280 --> 0:17:19.480 maggots who, like you said, erin, are seeking out the deepest, 0:17:19.720 --> 0:17:23.080 most necrotic tissue because that's the areas of greatest food 0:17:23.200 --> 0:17:27.280 for them. So they are incredibly efficient at this debreatment process. 0:17:28.520 --> 0:17:33.919 Do we know what chemicals and enzymes and what's in 0:17:33.960 --> 0:17:37.399 their secretions? Can we mimic it? Would we want to 0:17:37.440 --> 0:17:38.600 ever mimic it? 0:17:38.600 --> 0:17:40.000 It's a great, great question. 0:17:40.040 --> 0:17:41.840 I feel like that is one of the big questions 0:17:41.880 --> 0:17:45.040 about so many of the things with maggots and with leeches, 0:17:45.080 --> 0:17:48.240 like we'll talk about later. We know some of the compounds, 0:17:48.320 --> 0:17:51.840 A lot of them are like proteolytic enzymes and a 0:17:51.880 --> 0:17:55.680 bunch of other things as well too. There certainly are 0:17:56.359 --> 0:17:58.479 compounds that we have that we might use that are 0:17:58.560 --> 0:18:03.119 very similar. But as we'll see, it's like it's a combination, right, 0:18:03.160 --> 0:18:06.600 Like it isn't just the chemicals that they're secreting. It's 0:18:06.640 --> 0:18:09.040 also the way that they're moving. It's their mouth parts 0:18:09.080 --> 0:18:11.080 doing the things that they're doing. It's them scooting their 0:18:11.080 --> 0:18:13.919 bodies along. So yes, it is possible, and I think 0:18:13.960 --> 0:18:16.040 we'll talk a lot more about that idea of like 0:18:16.119 --> 0:18:19.080 can we identify these specific compounds and can we mimic them. 0:18:19.320 --> 0:18:22.760 Well, it's also like just the removal process, like you said, 0:18:22.840 --> 0:18:26.400 like it's not just dissolving, yeah or whatever. 0:18:26.440 --> 0:18:44.160 Sucking it up too, They're amazing, but that's not all. 0:18:44.160 --> 0:18:45.520 That's like not even close to all. 0:18:46.480 --> 0:18:49.879 So maggots because in the wild they're feeding on this 0:18:50.080 --> 0:18:55.320 decaying tissue that's just ripe with other organisms like bacteria, 0:18:55.400 --> 0:18:58.879 but also viruses, protozoans, other bugs like everything. 0:18:59.560 --> 0:19:00.600 So it makes. 0:19:00.240 --> 0:19:04.320 Sense that they would have also evolved ways to thrive 0:19:04.640 --> 0:19:08.640 in an environment that is chalk full of other microbes, right, 0:19:08.920 --> 0:19:13.360 ways of either outcompeting for food or making sure or 0:19:13.560 --> 0:19:17.000 and I guess making sure that they don't get infected 0:19:17.119 --> 0:19:20.439 with all of the other microorganisms that are around. And 0:19:20.520 --> 0:19:25.160 they do exactly that. Maggots secrete not just these enzymes 0:19:25.160 --> 0:19:28.080 that are breaking down tissue, but a whole host of 0:19:28.160 --> 0:19:32.600 anti microbial compounds that in studies have been shown to 0:19:32.640 --> 0:19:36.680 be active against things like staff and strep, which are 0:19:36.720 --> 0:19:41.880 really common skin flora, and interestingly, they're less effective perhaps 0:19:41.880 --> 0:19:45.359 against other types of bacteria which might be less common 0:19:45.400 --> 0:19:49.119 to be found on decaying carcasses. But on top of that, 0:19:49.160 --> 0:19:52.000 they're also eating a whole bunch of these microbes that 0:19:52.000 --> 0:19:57.400 could potentially be infecting a wound, so they're disinfecting the wound. 0:19:57.600 --> 0:20:01.960 They're controlling the infection of chronic wounds, and their little 0:20:02.040 --> 0:20:07.920 mouth hooks help to disrupt biofilm formation and biofilms win 0:20:08.040 --> 0:20:10.639 bacteria are able to like latch on and form a 0:20:10.640 --> 0:20:13.480 biofilm on top of a chronic wound. That is very 0:20:13.480 --> 0:20:16.800 difficult to deal with. And maggots are great at it. 0:20:17.600 --> 0:20:21.040 And if that wasn't enough, you're not yet convinced, listeners, 0:20:21.040 --> 0:20:23.640 because Aaron, I know you are. I'm sure that maggots 0:20:23.640 --> 0:20:26.439 are just like the bee's knees when it comes to 0:20:26.440 --> 0:20:32.520 wound healing. They literally help promote the healing of wounds. 0:20:33.000 --> 0:20:36.639 How So, wounds in many studies that have been treated 0:20:36.680 --> 0:20:41.639 with maggot therapy heal faster than wounds not treated with 0:20:41.680 --> 0:20:44.560 maggot therapy. So let's talk a little bit about what 0:20:44.600 --> 0:20:47.919 that means, Like, how do wounds actually heal. There's three 0:20:47.960 --> 0:20:52.480 major phases of wound healing. There's inflammation, proliferation like of 0:20:52.520 --> 0:20:56.760 the tissue, and then maturation. Chronic wounds, the type that 0:20:56.800 --> 0:21:01.399 are really like good for maggot therapy, are usually stuck 0:21:01.440 --> 0:21:04.920 in an inflammatory state, like they're stuck there and they 0:21:05.000 --> 0:21:09.320 just can't progress because of the necrotic tissue, because of bacteria, 0:21:09.359 --> 0:21:12.040 because of a whole bunch of stuff. Some of the 0:21:12.119 --> 0:21:18.320 secretions from magots act to inhibit this inflammation and that 0:21:18.480 --> 0:21:21.880 helps the wound to actually progress further through the stages 0:21:21.960 --> 0:21:26.240 of healing. And some of these compounds also seem to 0:21:26.280 --> 0:21:31.280 help to stimulate angiogenesis. Angiogenesis is the process of which 0:21:31.359 --> 0:21:34.280 we make new blood vessels so that you can get 0:21:34.320 --> 0:21:37.560 more oxygen to a wound, which, by the way, is 0:21:37.600 --> 0:21:42.280 how hyperbaric oxygen therapy works to help here wounds. And 0:21:42.320 --> 0:21:46.680 so this combination of things also helps to actually speed 0:21:46.800 --> 0:21:51.920 along the process of wound healing. So it's just amazing 0:21:52.000 --> 0:21:53.600 that maggots can do all of this. 0:21:54.080 --> 0:22:00.160 Yeah, why why do those things help wound? Like not why? 0:22:00.160 --> 0:22:03.600 But do you know what I mean, why, yeah, why not? 0:22:03.640 --> 0:22:05.160 Why? But also why that's all. 0:22:06.720 --> 0:22:08.960 I had the same thought, especially the idea that like, 0:22:09.040 --> 0:22:11.320 why would they be anti inflammatory? 0:22:11.359 --> 0:22:13.160 Because if a lot of what they are. 0:22:13.000 --> 0:22:16.600 Feeding on is like dead necrotic tissue in my brain, 0:22:16.600 --> 0:22:18.720 I wouldn't expect for there to necessarily be a lot 0:22:18.760 --> 0:22:21.640 of inflammation. But it seems like a lot of it 0:22:21.680 --> 0:22:24.960 is that they reduce some of the pro inflammatory cytokinds 0:22:25.000 --> 0:22:29.800 that we have circulating and reactive oxygen species. And reactive 0:22:29.840 --> 0:22:33.080 oxygen is something that definitely is present in the environment 0:22:33.119 --> 0:22:35.639 when cells start to lice, which is what's going to 0:22:35.720 --> 0:22:39.600 happen during necrosis and as something is decaying. So in 0:22:39.680 --> 0:22:41.480 that way, it kind of makes sense that it's to 0:22:41.520 --> 0:22:45.960 protect themselves, they're reducing reactive oxygen species. That's my best 0:22:46.040 --> 0:22:49.120 I didn't read that directly, but that's my best way 0:22:48.440 --> 0:22:50.439 of understanding it. 0:22:50.960 --> 0:22:54.240 Okay, can I ask some questions? 0:22:54.640 --> 0:22:57.639 Absolutely, Aaron, please, I have like two more pages of 0:22:57.640 --> 0:22:59.760 info I thought you might ask me questions about. 0:23:00.000 --> 0:23:01.960 Okay, let's stay if we can get through it now, 0:23:02.480 --> 0:23:05.679 I'm going to hit all those paragraphs. Yeah, okay, So 0:23:06.600 --> 0:23:11.120 when is maggot therapy indicated and when is it not. 0:23:11.560 --> 0:23:14.440 So that's a really good question. Chronic wounds is a 0:23:14.560 --> 0:23:16.880 very broad category. There's lots of different things that cause 0:23:16.960 --> 0:23:19.400 chronic wounds. There's lots of different types of chronic wounds. 0:23:20.080 --> 0:23:23.520 There isn't necessarily like one wound that is like, oh, 0:23:23.720 --> 0:23:26.840 definitely use maggots for this, and other wounds that you're like, ooh, 0:23:27.080 --> 0:23:30.240 never use maggots for this. In general, maggots are really 0:23:30.440 --> 0:23:34.600 safe to use for most all types of wounds, but 0:23:34.760 --> 0:23:37.879 any wounds that have a lot of necrotic tissue, like 0:23:38.000 --> 0:23:42.040 that dead tissue, anything that looks black on top is necrotic, 0:23:43.160 --> 0:23:47.040 that is going to be an especially good wound for 0:23:47.160 --> 0:23:48.639 maggots to be able. 0:23:48.480 --> 0:23:49.359 To be helpful for. 0:23:50.600 --> 0:23:53.400 They can be helpful in things like burns which need 0:23:53.480 --> 0:23:56.520 to breeding right away and in a pretty like gentle 0:23:56.680 --> 0:24:00.320 kind of way. And they're very helpful for any anything 0:24:00.359 --> 0:24:04.440 that's like difficult to reach or difficult to visualize, because 0:24:04.960 --> 0:24:07.560 they are going to crawl their way into nooks and 0:24:07.640 --> 0:24:11.119 crannies but then always come back up to the surface, 0:24:11.160 --> 0:24:13.399 either because they run out of food or because they 0:24:13.440 --> 0:24:16.080 need air, or because they're done growing and they need 0:24:16.119 --> 0:24:19.600 to mold. So really, like any type of skin and 0:24:19.760 --> 0:24:24.440 soft tissue wound could be amenable to maggot therapy, less 0:24:24.480 --> 0:24:29.679 so for things like bone and tendons and ligaments, just 0:24:29.720 --> 0:24:32.200 because all of these things that are so great about 0:24:32.200 --> 0:24:35.040 maggots don't work as well on those types of tissues. 0:24:35.920 --> 0:24:37.360 Interesting, okay, but. 0:24:37.320 --> 0:24:40.639 They're still not used as much as you would think. 0:24:40.520 --> 0:24:42.680 Given all of the benefits that I just mentioned. 0:24:42.800 --> 0:24:46.240 Yeah, So, like how many hospitals have a maggot colony. 0:24:46.800 --> 0:24:48.560 It's a great question. I have no idea. 0:24:48.760 --> 0:24:52.920 Okay, I think most hospitals probably have access to them 0:24:52.960 --> 0:24:55.280 in some capacity. I know when I have rotated through 0:24:55.320 --> 0:24:59.240 wound care they do use them sometimes, but in general 0:24:59.800 --> 0:25:02.439 they use them very often as kind of like a 0:25:02.560 --> 0:25:06.000 last resort rather than like a first line therapy, which I. 0:25:05.880 --> 0:25:07.080 Find really interesting. 0:25:07.400 --> 0:25:08.800 Is that just the ick factor. 0:25:09.560 --> 0:25:11.520 I think that's a big part of it. There's definitely 0:25:11.520 --> 0:25:14.959 a lot of research on like what is preventing people 0:25:15.080 --> 0:25:17.359 from using maggot therapy, and a lot of it comes 0:25:17.359 --> 0:25:19.960 back to either education, not knowing how great they can be, 0:25:20.040 --> 0:25:23.480 not knowing that they're effective, and like, yeah, the yuck factory, 0:25:23.760 --> 0:25:29.320