Department of Dermatology, University of Medical Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Department of Microbiology, İstanbul University, Cerrahpasa Medical Faculty, İstanbul, Turkey.
Clin Exp Dermatol. 2021 Jul;46(5):834-841. doi: 10.1111/ced.14539. Epub 2021 May 2.
Cutaneous ulcers of Behçet disease (BD) are rare but have high morbidity and resistance to conventional therapies. An important and essential aspect of ulcer management is debridement. Regarding maggot therapy (MT), excretions of the green bottle fly, Lucilia sericata, have been shown to have the ability to remove necrotic debris and promote healing.
To evaluate the efficacy of MT for cutaneous ulcers of BD.
In this open-label trial, patients with BD with refractory leg ulcers suitable for MT were enrolled. Maggot application was performed until complete debridement was achieved, and all patients were followed up for 12 months afterwards to assess the total healing of ulcers.
In total, 24 patients with 32 ulcers were enrolled. Using MT, 91.6% of all ulcers were completely debrided. Mean time to debridement was 14.9 days and mean number of cycles required was 5.3. Mean ulcer size was decreased by 23% with treatment. Time to debridement was positively correlated with pretreatment ulcer size and ulcer duration (P = 0.01 and P < 0.01) but not with ulcer depth, comorbidities, smoking, age or sex (P > 0.05 for all). During follow-up, 79.1% of all ulcers healed completely. Mean time required for total healing was positively correlated with ulcer duration, pretreatment and post-treatment ulcer area, ulcer depth and mean time to total debridement (P < 0.03, P = 0.00, P = 0.04 and P < 0.01, respectively).
To our knowledge, the findings presented in this first and unique study may provide key answers about factors affecting success rate of MT in BD cutaneous ulcers.
贝赫切特病（BD）的皮肤溃疡罕见，但发病率高，且对常规治疗有耐药性。溃疡处理的一个重要且必不可少的方面是清创。关于蝇蛆疗法（MT），绿头苍蝇（Lucilia sericata）的分泌物已被证明具有清除坏死碎片和促进愈合的能力。
评估 MT 治疗 BD 皮肤溃疡的疗效。
在这项开放标签试验中，招募了适合 MT 的难治性腿部溃疡的 BD 患者。进行蛆虫应用，直到完全清创，所有患者在 12 个月后进行随访，以评估溃疡的总愈合情况。
共纳入 24 例 32 个溃疡患者。使用 MT，所有溃疡的 91.6%完全清创。清创的平均时间为 14.9 天，平均需要 5.3 个周期。治疗后平均溃疡面积减少 23%。清创时间与治疗前溃疡大小和溃疡持续时间呈正相关（P=0.01 和 P<0.01），但与溃疡深度、合并症、吸烟、年龄或性别无关（P>0.05）。在随访期间，所有溃疡中有 79.1%完全愈合。完全愈合所需的平均时间与溃疡持续时间、治疗前和治疗后溃疡面积、溃疡深度以及总清创时间呈正相关（P<0.03，P=0.00，P=0.04 和 P<0.01）。
据我们所知，本项首次且独特的研究中的发现可能为影响 MT 在 BD 皮肤溃疡中成功率的因素提供关键答案。
