WELSH MAGGOTS are helping Tayside diabetics tackle MRSA, fight infection and reduce the risk of having their feet amputated, writes Marjory Inglis, health reporter.

At a conference held in Dundee yesterday, clinicians from all over the UK involved in the care of diabetics, heard about the success of maggots in clearing up serious infections.

NHS Tayside’s team leader for diabetes Dr Graham Leese said that foot ulcers and infection, which can lead to amputation, are a complication of diabetes.

Open wounds such as ulcers can be a route that allows dangerous bugs, such as the antibiotic-resistant MRSA, to enter the bloodstream and cause serious problems. But maggots that literally chew up the infection are proving effective. They are applied to the infected feet of diabetics being treated in Ninewells Hospital, Dundee.

The maggots come from a surgical materials laboratory in Wales that is the sole supplier of maggots for medical use.

“We use them on foot ulcers because the ulcers often have a lot of dead tissue which takes a long time to get rid of,” said Dr Leese.

“In these situations maggots can accelerate the healing process and get rid of infection. They are particularly good when tackling MRSA and you want to avoid using antibiotics.”

Extensive use of antibiotics can lead to their becoming ineffective and doctors now try to rely on other methods of treatment, saving antibiotics for tackling the most serious problems that will not respond to anything else.

“If you get infection in the ulcer that can be a portal for getting infection into the bone and deep tissues,” said Dr Leese. “That is when you get the risk of amputation.”

Dr Leese said there was “scope” to introduce maggots to tackle other areas of infection beyond the foot. It was being used on a limited basis in other departments at the hospital.

A workshop was held on the use of maggots in foot care at the Scottish Practical Diabetes Foot Conference at Westpark Conference Centre yesterday.

More than 140 healthcare professionals from all over the UK attended the conference, organised by Dr Leese, to share new developments on the management and prevention of foot problems associated with diabetes.

Those attending also heard about the Ninewells clinic that brought together nurses, doctors, podiatrists and orthotists to provide a one-stop service to diabetics with foot problems.

“We all get together to give a unified opinion there and then,” said Dr Leese, adding that the weekly clinic celebrates its ninth birthday this week.

He said clinicians from other areas of Scotland who did not have a one-stop foot clinic were interested in the Tayside example and keen to introduce something similar in their own hospitals.

Key speakers at the conference included Dr Mike Edmonds, a diabetic consultant from London, who talked about Charcot foot. A feature of the complex condition is that all the bones of the foot start to fracture and heal in a very unusual shape, making walking and wearing shoes extremely difficult.

Also speaking were local expert Dr Rami Abboud, a senior lecturer at the Tayside Orthopaedic and Rehabilitation Technology Centre at Ninewells Hospital and Dr Gerry Rayman, a diabetic consultant. Dr Abboud discussed the usefulness of assessing walking patterns for predicting the risk of developing foot problems, while Dr Rayman contributed as an expert on diabetes foot disease and diabetic neuropathy.