Maggot therapy in "Lower-extremity hospice" wound care - Fewer amputations and more antibiotic-free days
Maggot therapy in "Lower-extremity hospice" wound care - Fewer amputations and more antibiotic-free days
复制标题
DOI：
10.7547/0950254
复制
发表时间：
2005-05-01
影响因子：
0.7
通讯作者：
Boulton, AJM
中科院分区：
文献类型：
--
作者：
Armstrong, DG;Short, B;Boulton, AJM
在病例对照模型中，我们试图评估60名不能行走的患者(平均+/-SD年龄，72.2+/-6.8岁)接受蝇虫清创治疗的潜在疗效，这些患者患有神经缺血型糖尿病足创面(德克萨斯大学脚踝以下的C级或D级创面)和周围血管病变。其中27名患者(45%)在6个月的复查中痊愈。治疗组患者的愈合率与对照组相比差异无统计学意义(57%对33%)。在痊愈的患者中，蚯蚓疗法的愈合时间显著短于对照组(18.5±4.8周比22.4±4.4周)。大约五分之一的患者(22%)接受了高位(足部以上)截肢。对照组患者接受截肢的可能性是对照组的三倍(33%比10%)。尽管接受蝇虫治疗的患者的感染率与对照组相比没有显著差异(80%对60%)，但接受蝇虫治疗的患者在随访期间无抗生素的天数显著增加(126.8+/-30.3天比81.9+/-42.1d)。蛆清创疗法可降低糖尿病足伤口非卧床患者的短期发病率。
We sought to assess, in a case-control model, the potential efficacy of maggot debridement therapy in 60 nonambulatory patients (mean +/- SD age, 72.2 +/- 6.8 years) with neuroischemic diabetic foot wounds (University of Texas grade C or D wounds below the malleoli) and peripheral vascular disease. Twenty-seven of these patients (45%) healed during 6 months of review. There was no significant difference in the proportion of patients healing in the maggot debridement therapy versus control group (57% versus 33%). Of patients who healed, time to healing was significantly shorter in the maggot therapy than in the control group (18.5 +/- 4.8 versus 22.4 +/- 4.4 weeks). Approximately one in five patients (22%) underwent a high-level (above-the-foot) amputation. Patients in the control group were three times as likely to undergo amputation (33% versus 10%). Although there was no significant difference in infection prevalence in patients undergoing maggot therapy versus controls (80% versus 60%), there were significantly more antibiotic-free days during follow-up in patients who received maggot therapy (126.8 +/- 30.3 versus 81.9 +/- 42.1 days). Maggot debridement therapy reduces short-term morbidity in nonambulatory patients with diabetic foot wounds.