Gottrup Finn, Jørgensen Bo
Copenhagen Wound Healing Center, Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
Eplasty. 2011;11:e33. Epub 2011 Jul 12.
Debridement is an essential component to promote healing in a problem wound. Several techniques are available including maggot debridement therapy (MDT).
To describe the efficacy of MDT for treating problem wound especially diabetic foot ulcers.
The topic is elucidated from different points of view: the mode of action, when to use, use in a practice, clinical results, and discussing the problem of creating evidence for the clinical effect.
Literature and own results demonstrate that MDT is a safe method with few side effects. Maggot debridement therapy is as good as or better than conventional often surgical debridement, is more selective than surgical debridement, decreases time to healing and stay of patients in the ward, and may decrease the risk of major amputations. However, the evidence of these effects of MDT on the highest level is presently lacking. A detailed description of how to use MDT in practice is provided including a visual demonstration in a video.
In spite of lacking clinical evidence, MDT clinical experience strongly suggests that this technique is effective and safe. It can be used for most types of problem wounds, but our indication is primarily diabetic foot ulcers, because of its selectivity for debriding necrotic dead tissue. It may be a valuable alternative surgical/sharp debridement.
清创术是促进难愈伤口愈合的重要组成部分。有多种技术可供选择，包括蛆虫清创疗法（MDT）。
描述蛆虫清创疗法治疗难愈伤口尤其是糖尿病足溃疡的疗效。
从不同角度阐述该主题：作用方式、使用时机、在实践中的应用、临床结果以及讨论为临床效果建立证据的问题。
文献及自身结果表明，蛆虫清创疗法是一种安全且副作用少的方法。蛆虫清创疗法与传统的通常为手术清创一样好或更好，比手术清创更具选择性，可缩短愈合时间和患者在病房的住院时间，并可能降低大截肢的风险。然而，目前缺乏关于蛆虫清创疗法这些效果的最高级别证据。提供了在实践中如何使用蛆虫清创疗法的详细描述，包括视频中的直观演示。
尽管缺乏临床证据，但蛆虫清创疗法的临床经验强烈表明该技术有效且安全。它可用于大多数类型的难愈伤口，但我们的主要适应证是糖尿病足溃疡，因为其对坏死组织清创具有选择性。它可能是手术/锐性清创的一种有价值的替代方法。
