Maggot therapy for the treatment of intractable wounds

Mumcuoglu, Kosta Y.; Ingber, Arieh; Gilead, Leon; Stessman, Jochanan; Friedmann, Reuven; Schulman, Harold; Bichucher, H; Ioffe-Uspensky, I; Miller, Jacqueline M.; Galun, Rachel; I, Raz

doi:10.1046/j.1365-4362.1999.00770.x

Cited by 135 publications

(95 citation statements)

References 15 publications

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“…[17][18][19]21,22 ) and experience with the technique (Box 1). 25 Patients were recorded as overweight accordingly.…”

Section: Outcomementioning

confidence: 99%

“…21 Success rates of MDT, reported in the literature, vary, but seem to be around 80-90%. 18,19,22 The present study discusses the observations of MDT in patients with complex and chronic wounds in whom major limb amputation or sepsis was the only alternative, if no MDT would be performed. In total, 101 patients with 117 wounds, seen in our surgical department, were treated.…”

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confidence: 99%

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Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

Steenvoorde

Jacobi

Doorn

et al. 2007

annals

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INTRODUCTION It has been known for centuries that maggots are potent debriding agents capable of removing necrotic tissue and slough. In January 2004, the US Food and Drug Administration decided to regulate maggot debridement therapy (MDT). As it is still not clear which wounds are likely or unlikely to benefit from MDT, we performed a prospective study to gain more insight in patient and wound characteristics influencing outcome. PATIENTS AND METHODS In the period between August 2002 and December 2005, patients with infected wounds with signs of gangrenous or necrotic tissue who seemed suited for MDT were enrolled in the present study. In total, 101 patients with 117 ulcers were treated. Most wounds were worst-case scenarios, in which maggot therapy was a treatment of last resort. RESULTS In total, 72 patients (71%) were classified as ASA III or IV. In total, 78 of 116 wounds (67%) had a successful outcome. These wounds healed completely (n = 60), healed almost completely (n = 12) or were clean at least (n = 6) at last follow-up. These results seem to be in line with those in the literature. All wounds with a traumatic origin (n = 24) healed completely. All wounds with septic arthritis (n = 13), however, failed to heal and led in half of these cases to a major amputation. According to a multivariate analysis, chronic limb ischaemia (odds ratio [OR], 7.5), the depth of the wound (OR, 14.0), and older age (≥ 60 years; OR, 7.3) negatively influenced outcome. Outcome was not influenced by gender, obesity, diabetes mellitus, smoking, ASAclassification, location of the wound, wound size or wound duration. CONCLUSIONS Some patient characteristics (i.e. gender, obesity, smoking behaviour, presence of diabetes mellitus and ASA-classification at presentation) and some wound characteristics (i.e. location of the wound, wound duration and size) do not seem to contra-indicate eligibility for MDT. However, older patients and patients with chronic limb ischaemia or deep wounds are less likely to benefit from MDT. Septic arthritis does not seem to be a good indication for MDT.

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“…[17][18][19]21,22 ) and experience with the technique (Box 1). 25 Patients were recorded as overweight accordingly.…”

Section: Outcomementioning

confidence: 99%

mentioning

confidence: 99%

Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

Steenvoorde

Jacobi

Doorn

et al. 2007

annals

View full text Add to dashboard Cite

show abstract

“…By 1934, more than 1,000 surgeons were using maggot therapy, the surgical maggot were available commercially from Lederle Corporation (18). MDT is indicated for open wounds and ulcers that contain gangrenous or necrotic tissues with or without infection (19). It was reported that larvae and their secretions have antibacterial effects, reduce inflammation as well as neo-angiogenesis, and improve wound healing.…”

Section: Introductionmentioning

confidence: 99%

Maggot Debridement Therapy for Diabetic Foot Ulcer: A Case Report

Hajimohammad¹,

Esmaili²,

Rahimi³

2017

Crit Care Nurs J

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Introduction: Diabetic foot problems account for more hospital admissions than any other long term complications of diabetes and are responsible for nearly 50% of all-diabetes-related hospital bed days. Maggot debridement therapy (MDT) offers important advantages for the management of chronic and infected wounds and is used in hundreds of clinics worldwide. This study aimed to evaluate the benefit of maggot debridement therapy (MDT) in the treatment of a patient with a diabetic foot ulcer (DFU). Case Presentation: A 46-year-old male patient with a 6-year-old diabetic foot wound in the right leg. Maggot larvae were placed on the wound. The patient was followed for 6 weeks and luckily had a good response to treatment. Conclusions: This study concluded that MDT is as powerful as traditional debridement in the treatment of diabetic foot ulcers. It would be an achievable different option for diabetic foot ulcer treatment. In conclusion, we observed that MDT could promote wound healing by increasing endothelial proliferation, triggering angiogenesis, and maggot excretion/secretion, which might facilitate this process.

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“…4) While its therapeutic effects vary among reports, MDT has been effective in about 80%-90% of patients. [5][6][7] MDT has also been reported to be effective for the treatment of pressure ulcer, 8) burn injury, 9) osteomyelitis, 10) diabetic ulcer, 11) ulcers associated with venous stasis, 12) MRSA infection, 13) and chronic intractable ulcers. 14) Age has been suggested as a factor that affects the therapeutic effect of MDT, 15) but these factors have not been evaluated in detail.…”

Section: Disclosure Statementmentioning

confidence: 99%