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.

Keywords: diabetic foot syndrome, infected foot wounds, maggot debridement therapy
p. 57 67 of the original issue
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Address for correspondence:
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
Information about the authors:
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."
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