THE SUCCESS OF RAPID DEBRIDEMENT BY LARVAL THERAPY

(a case report)

Aleksandra Żyjewska-Złotowska RN, MSc, Gdynia, Poland (olazyjewska@gmail.com)

Elżbieta Buszko-Sikora MD, Bydgoszcz, Poland

Case report

Aim: This case demonstrate the effectiveness of debridement

by larval therapy in the healing of a sloughy venous leg ulcer.

Methods: The 66-year-old patient was first assessed for larval

therapy on February 16, 2012, with a venous leg ulcers on his left leg, and vast surface was macerated. His wound appeared on December 2010. Sterile and free-range Lucilia sericata were applied twice. Maggots were applied in maximum quantity ten for every 1cm2, and left for 4 days each time. Everyday on the external part of the dressing was changed. After second time 80% of ulcer were clean from necrotic tissue. Between maggot therapy and after, his wound was dressed with hydrocolloid pads. Compression therapy and regular mechanical cleaning was also implemented. Skin around ulcer was protected with liquid paraffin.

Results: Photographic documentation revealing different stages in the reduction of the wound. Furthermore, there was observed ensuant reduction of pain in one month, during dressing changes

Before Maggot Therapy After 4 days taking off maggots

Venous ulcer leg cleaned by maggots

Wound in July, regular mechanical cleaning was implemented every 4 days.

Wound in November.After 8 moths and 3 weeks wound healed.

Conclusions

Maggots can efficiently debride necrotic wound tissue and promote healing.

However treatment did not lead to healing. Maggot debridment therapy may be

implemented safely also in hospitals outpatients departments or in others ambulatory patient.