Novosti
|
This journal is indexed in Scopus |
---|
Year 2013 Vol. 21 No 6
GENERAL AND SPECIAL SURGERY
V.I. RUSIN, V.V. KORSAK, P.A. BOLDIZHAR, A.A. NOSENKO
TREATMENT OF PATIENTS WITH DIABETIC FOOT SYNDROME BY LUCILIA SERICATA LARVAE
SHEE “Uzhgorod National University”,
The Ukraine
Objectives. To improve treatment results of patients with the diabetic foot syndrome (DFS) by introducing method of wound healing by flies larvae (Lucilia sericata) for the debridement of wounds in the clinical practice.
Methods. 50 patients with infected foot wounds were selected for the study: 35 patients with a neuropathic form of DFS and 15 – with a neuroischemic form. The depth of lesions was II-III grade according to Wagner classification. Larvae therapy involves applying bandage with maggots to a wound according the appropriate method to help it heal.
Results. The medical use of live maggots (fly larvae) for treating non-healing wounds showed a complete cleaning of a wound after one course of introduction of maggots to a wound removed dead tissue from it in 8 (16%) cases, after two courses – in 23 (46%), after three courses – in 14 (28%), after four and further courses – in 5 (10%) cases. For local therapy the special medical bandage and hydrogel were used after complete washing out of the wound by larvae to promote the formation of granulation tissue in a clean healthy wound in 35 (70%) patients. Various terms of complete wound healing by the secondary tension were registered. To close the large smooth wound surface the autodermoplasty was performed in 15 (30%) patients. Good engraftment rates of the graft was marked in all the cases. Three primary actions of medical grade maggots on wounds: the cleaning the wound by dissolving dead and infected tissue, disinfection of wounds by killing bacteria and promotion of the wound healing. Maggot debridement therapy (MDT) is characterized by high effectiveness marked by the reduction of wound cleaning time and treatment cost.
Conclusions. Wound healing by larvae Lucilia Sericata is considered as an effective and safe method than conventional treatment. The larvae remove the dead tissue leaving viable tissue unharmed and stimulate the complete healing of the wound in 68,6% cases during three months. Maggot wound cleaning should be used as a preparatory step before performances of autodermoplasty.
- Udovichenko OV, Grekova NM. Diabeticheskaia stopa [Diabetic foot]. Moscow, RF: Prakt meditsina, 2010. 272 p.
- Bregovskii VB, Zaitsev AA, Zalevskaia AG, Karpov IA, Karpov OI, Tsvetkova TL. Porazhenie nizhnikh konechnostei pri sakharnom diabete [The lesion of the lower limbs in diabetes]. Moscow – Saint-Petersburg, RF: Dilia, 2004. p. 7-11.
- Sherman RA. Maggot therapy takes us back to the future of wound care: new and improved maggot therapy for the 21st century. J Diabetes Sci Technol. 2009 Mar 1;3(2):336–44.
- Whitaker IS, Twine C, Whitaker MJ, Welck M, Brown CS, Shandall A. Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential. Postgrad Med J. 2007 Jun;83(980):409–13.
- Nigam Y, Bexfield A, Thomas S, Ratcliffe NA. Maggot Therapy: The Science and Implication for CAM Part I-History and Bacterial Resistance. Evid Based Complement Alternat Med. 2006 Jun;3(2):223–27.
- Fleischmann W, Grassberger M, Sherman R. Maggot therapy: a handbook of maggot-assisted wound healing complementary medicine. Stuttgart Germany: George Thieme Verlag; 2004. p. 93.
- Sherman RA, Wyle F, Vulpe M. Maggot therapy for treating pressure ulcers in spinal cord injury patients. J Spinal Cord Med. 1995 Apr;18(2):71–4.
- Cerovsky V, Zdarek J, Fucik V, Monincova L, Voburka Z, Bem R. Lucifensin, the long-sought antimicrobial factor of medicinal maggots of the blowfly Lucilia sericata. Cell Mol Life Sci. 2010 Feb;67(3):455–66.
- Blaizot X, Mourgeon B, Chene Y, Creveuil C, Combemale P, Laplaud AL, Sohyer-Lebreuilly I, Dompmartin A. Maggot therapy for wound debridement: a randomized multicenter trial. Arch Dermatol. 2012 Apr;148(4):432–38.
- Rusin VІ, Korsak VV, Nosenko OA. Zasіb for lіkuvannya hronіchnih wounds [The treatment for chronic wounds]. The patent of Ukraine N 78978; № u2012, 10440, zaiavl 04.09.2012; opubl 10.04.2013. Bull (7).
- Rusin VІ, Korsak VV, Nosenko OA, Mitrovka BA. Sposіb lіkuvannia khronіchnikh ran [A method for treating chronic wounds]. Patent of Ukraine №79018; № u2012, 11102; zaiavl 24.09.2012; Opubl. 10.04.2013. Biul;(7).
- Nigam Y, Bexfield A, Thomas S, Ratcliffe NA. Maggot Therapy: The Science and Implication for CAM Part I-History and Bacterial Resistance. Evid Based Complement Alternat Med. 2006 Jun;3(2):223–27.
- Armstrong DG, Salas P, Short B, Martin BR, Kimbriel HR, Nixon BP, Boulton AJ. Maggot therapy in "lower-extremity hospice" wound care: fewer amputations and more antibiotic-free days. J Am Podiatr Med Assoc. 2005 May-Jun;95(3):254-57.
- Wang SY, Wang JN, Lv DC, Diao YP, Zhang Z. Clinical research on the bio-debridement effect of maggot therapy for treatment of chronically infected lesions. Orthop Surg. 2010 Aug;2(3):201-6.
88010, Ukraina, g. Uzhgorod, ul. Kapushanskaia, d. 22, GVUZ «Uzhgorodskii natsional'nyi uni-versitet», Zakarpatskaia oblastnaia klinicheskaia bol'nitsa im. A. Novaka», kafedra khirurgicheskikh boleznei,
e-mail: vyacheslav_korsak@ukr.net,
Korsak Viacheslav Vasil'evich
Rusin V.I. MD, professor, a head of a chair of surgical diseases of SHEE "Uzhgorod National University."
Korsak V.V. MD, professor of a chair of surgical diseases of SHEE "Uzhgorod National University."
Boldizhar P.O. MD, professor of a chair of surgical diseases of SHEE "Uzhgorod National University."
Nosenko A.A. A graduate student of a chair of surgical diseases of SHEE "Uzhgorod National University."