title: Maggot debridement therapy for peripheral arterial disease.
abstract: BACKGROUND
  Maggots are potent debriding agents capable of removing necrotic tissue and slough; however, it is still unclear which wounds are most likely to benefit from maggot debridement therapy (MDT). Thus, we performed this retrospective review to gain insight into the patient and therapy characteristics influencing outcome.
  
  
  METHODS
  We reviewed patients with foot ulcers caused by critical limb ischemia, encountered during the period between June 2005 and May 2010. The treatment outcomes were defined as effective or ineffective.
  
  
  RESULTS
  There were 16 patients with 16 leg ulcers. The patients were 13 men and 3 women, with an average age of 67.2 years (range, 47-85 years). Ten (63%) of the 16 ulcers were treated effectively. According to univariate analyses, an ankle brachial pressure index (ABI) lower than 0.6 (p = 0.03) had a negative impact on the outcome of MDT; however, outcome was not influenced by gender, obesity, ischemic heart disease, diabetes mellitus, hemodialysis, smoking, or laboratory findings.
  
  
  CONCLUSIONS
  Some patient characteristics, such as gender, obesity, ischemic heart disease, diabetes mellitus, hemodialysis, and smoking, do not seem to contraindicate eligibility for MDT. However, a limb with an ABI lower than 0.6 is less likely to benefit. (English Translation of J Jpn Coll Angiol 2011; 51: 209-213.).
authors.affiliation: Department of Vascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Igari
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyofuku
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Shinya
authors.initials: S
authors.lastname: Koizumi
authors.forename: Koji
authors.initials: K
authors.lastname: Yonekura
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Jibiki
authors.forename: Norihide
authors.initials: N
authors.lastname: Sugano
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Inoue
keywords: foot ulcer; maggot debridement therapy; necrotic foot; peripheral arterial disease