Maggot therapy is more successful
in debriding nonhealing ulcers than is continued conventional care.
That, according to the results of a
retrospective review published in the February issue of Diabetes Care.
The investigators suggest that this therapy is worthy of further research to
properly define its role.
"Over the past few years, there has
been a resurgence in the use of maggot therapy, even though its optimal role has
not been clearly defined," write Ronald A. Sherman, MD, MSC, and colleagues from
the Veterans Affairs Medical Center in Long Beach and the University of
California, Irvine. "Large prospective clinical trials have not been conducted
for maggot therapy, and there are no commercial backers to support such
studies."
In the study, of 20
nonhealing ulcers in 18 patients, six wounds were treated with conventional
therapy, six with maggot therapy, and eight with conventional therapy followed
by maggot therapy.
Although
conventional therapy failed to achieve any significant debridement during the
first 14 days, maggot therapy allowed necrotic tissue to decrease by an average
of 4.1 cm2
during the same time frame (P = .02). After five weeks of therapy,
necrotic tissue still covered more than 33% of the surface of conventionally
treated wounds, but maggot-treated wounds were completely debrided after four
weeks of therapy (P = .001). Growth of granulation tissue was faster and
wound healing rates were also better with maggot therapy.
"Maggot therapy was more effective and efficient in debriding nonhealing foot and leg ulcers in male diabetic veterans than was continued conventional care," the authors write. "In addition to issues of efficacy and safety, future studies also must address the cost-effectiveness of maggot debridement therapy and conditions in which [it] is likely to be futile."
Source: Diabetes In Control Dot
Com: Diabetes Care.
2003;26:446-451
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