We present a case of 57 year old man with diabetic ulcer post amputation of his 5th toe in which Maggot Therapy was used with astounding result.
History
Mr. R who has background history of poorly controlled diabetes, underwent a Ray's amputation of his fifth right toe one week earlier. Following that, we noticed that the wound was slowly healing despite strict two times daily dressing with antiseptics.
With the advice of a senior colleague, we introduced a type of alternative, natural method to speed up the healing process.This is called Maggot Therapy or Maggot Debridement Therapy (MDT).
The Method
Day 0-observe the slough (dead tissue) inside the wound
Day 0-About 300 maggots were applied to the wound.(observe the tiny size of each of them).The gauze was put around the wound as 'doughnut' shape to avoid the maggots from escaping.
The maggots were left in the wound for 48 hours
Day 2 -look at the 'well-fed' maggots!
Day 2-the wound after all the maggots taken out.much better!
Day 10- the completely healed wound!
Conclusion
Maggot therapy is an effective and safe method to be used together with modern medicine to treat slow healing wounds.
Discussion
Maggot Debridement Therapy (MDT) is the medical use of specially selected and tested, disinfected fly larvae ("maggots") for cleaning non-healing wounds.
Medicinal maggots have been found to have four principle actions: 1) they debride (clean) wounds by dissolving the dead (necrotic), infected tissue; 2) they disinfect the wound, by killing bacteria; and 3) they stimulate wound healing; and 4) they break down and inhibit the formation of biofilm.
Historically, maggots have been known for centuries to help heal wounds. Many military surgeons noted that soldiers whose wounds became infested with maggots did better --- and had a much lower mortality rate --- than did soldiers with similar wounds not infested. William Baer, at Johns Hopkins University in Baltimore, Maryland, was the first physician (an orthopedic surgeon, actually) in the U.S. to actively promote maggot therapy; his results were published posthumously by his colleagues in 1931. MDT was successfully and routinely performed by thousands of physicians until the mid-1940's, when its use was supplanted by the new antibiotics and surgical techniques that became available by the end of World War II.
Maggot therapy was occasionally used during the 1970's and 1980's, when antibiotics, surgery, and other modalities of modern medicine failed. In 1989, physicians at the Veterans Affairs Medical Center in Long Beach, CA, and at the University of California, Irvine, reasoned that if maggot therapy was effective enough to treat patients who otherwise would have lost limbs, despite modern surgical and antibiotic treatment, then perhaps we should be using maggot therapy before the wounds progress that far, and not only as a last resort. It was on this hypothesis that the modern era of maggot therapy was born. With repeated conttrolled studies demonstrating enhanced wound debridement and luscious healthy granulation tissue growing where once only necrotic (gangrenous) tissue was visible, maggot therapy has once again been adopted by thousands of modern wound treatment centers around the world.
Further info:-
No comments:
Post a Comment