Sherman Ronald A
Veterans Affairs Medical Center, Long Beach, California and the Department of Medicine, University of California, Irvine 92697, USA.
Diabetes Care. 2003 Feb;26(2):446-51. doi: 10.2337/diacare.26.2.446.
To assess the efficacy of maggot therapy for treating foot and leg ulcers in diabetic patients failing conventional therapy.
Retrospective comparison of changes in necrotic and total surface area of chronic wounds treated with either maggot therapy or standard (control) surgical or nonsurgical therapy.
In this cohort of 18 patients with 20 nonhealing ulcers, six wounds were treated with conventional therapy, six with maggot therapy, and eight with conventional therapy first, then maggot therapy. Repeated measures ANOVA indicated no significant change in necrotic tissue, except when factoring for treatment (F [1.7, 34] = 5.27, P = 0.013). During the first 14 days of conventional therapy, there was no significant debridement of necrotic tissue; during the same period with maggot therapy, necrotic tissue decreased by an average of 4.1 cm(2) (P = 0.02). After 5 weeks of therapy, conventionally treated wounds were still covered with necrotic tissue over 33% of their surface, whereas after only 4 weeks of therapy maggot-treated wounds were completely debrided (P = 0.001). Maggot therapy was also associated with hastened growth of granulation tissue and greater wound healing rates.
Maggot therapy was more effective and efficient in debriding nonhealing foot and leg ulcers in male diabetic veterans than was continued conventional care.
评估蛆虫疗法对常规治疗无效的糖尿病患者足部和腿部溃疡的疗效。
对采用蛆虫疗法或标准（对照）手术或非手术疗法治疗的慢性伤口的坏死面积和总面积变化进行回顾性比较。
在这个由18名患者的20处未愈合溃疡组成的队列中，6处伤口采用常规疗法治疗，6处采用蛆虫疗法治疗，8处先采用常规疗法，然后采用蛆虫疗法治疗。重复测量方差分析表明，除了考虑治疗因素外，坏死组织没有显著变化（F [1.7, 34] = 5.27，P = 0.013）。在常规治疗的前14天，坏死组织没有明显清创；在蛆虫疗法治疗的同一时期，坏死组织平均减少了4.1平方厘米（P = 0.02）。治疗5周后，常规治疗的伤口仍有超过33%的表面覆盖着坏死组织，而蛆虫治疗的伤口在仅治疗4周后就完全清创（P = 0.001）。蛆虫疗法还与肉芽组织生长加快和伤口愈合率提高有关。
在清创男性糖尿病退伍军人不愈合的足部和腿部溃疡方面，蛆虫疗法比持续的常规护理更有效且更高效。
