title: [Comparative study of the efficacy of larva therapy for debridement and control of bacterial burden compared to surgical debridement and topical application of an antimicrobial].
abstract: Maggot debridement therapy (MDT) is the use of medical grade maggots of the fly Lucilia sericata for wound debridement. Recent observations show that MDT decreases bacterial burden as well. Venous ulcers are the most commonly seen in wound clinics and require, besides adequate treatment of venous hypertension, proper wound bed preparation with debri dement of necrotic tissue and control of potential infections. To evaluate the efficacy of MDT in venous ulcers a randomized controlled trial was designed to compare MDT to surgical debridement and topical application of silver sulfadiazine (SSD) in 19 patients for 4 weeks. The study variables were area reduction, wound bed characteristics, pain, odor, anxiety and bacterial burden using quantitative tissue biopsies. MDT was effective as surgical debridement associated with topical SDD in the debridement of the wound and in reducing its size. A significant difference was observed in the reduction of bacterial burden in favor of the MDT group. Odor and anxiety increased in the MDT group without any difference in the pain intensity between groups. In conclusion, this study suggests that MDT is as effective as surgical debridement for the debridement of necrotic tissue and promote wound healing in venous ulcers and better at reducing bacterial burden.
authors: Sección de Clínica Interdisciplinaria de Cuidado de Heridas y Estomas, División de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors: José
authors: J
authors: Contreras-Ruiz
authors: Sección de Clínica Interdisciplinaria de Cuidado de Heridas y Estomas, División de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors: Adán
authors: A
authors: Fuentes-Suárez
authors: Laboratorio de Microbiología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors: Sara
authors: S
authors: Arroyo-Escalante
authors: Laboratorio de Microbiología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors: David
authors: D
authors: Moncada-Barron
authors: Departamento de Investigación, Instituto Nacional de Pediatría, Ciudad de México, México.
authors: María Cristina
authors: MC
authors: Sosa-de-Martínez
authors: Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors: Ernesto
authors: E
authors: Maravilla-Franco
authors: Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
authors: Judith Guadalupe
authors: JG
authors: Domínguez-Cherit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control*; D003646:Debridement / Q000379:methods*; D004175:Diptera; D006801:Humans; D007814:Larva; D008875:Middle Aged; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D014647:Varicose Ulcer / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D014945:Wound Healing
chemical_list: D000891:Anti-Infective Agents, Local; D012837:Silver Sulfadiazine