Hajimohammadi Kazem, Parizad Naser, Hassanpour Amireh, Goli Rasoul
Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Urmia, Iran.
Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Int J Surg Case Rep. 2021 Sep;86:106334. doi: 10.1016/j.ijscr.2021.106334. Epub 2021 Aug 25.
A diabetic foot ulcer (DFU) is one of the major diabetes complications that may lead to limb amputation. Amputation can have profound physical and psychological effects on an individual's life. Nowadays, the prevention of limb amputation and treatment of DFUs are known as the major health challenges.
The present case report is of a 72-year-old woman with a 20-year history of type 2 diabetes who has had asymmetrical and superficial DFUs with sizes of 6 × 5 cm and 3 × 3 cm on the heel and the sole of the right foot, respectively. The ulcers were infected by S. aureus and E. coli. The patient had been hospitalized several times for receiving treatment, and not only the ulcers had not been healed, but also they had considerably extended so that the risk of foot amputation had been greatly increased. The patient was transferred to our wound care service. After conducting one session of surgical debridement, the patient underwent ten sessions of maggot therapy (one session every two days) using sterile Lucilia sericata. After about six months, the patient's DFUs were completely healed.
DFU can affect a patient's quality of life and lead to infection, sepsis, amputation, and even patient death. Therefore, using effective treatment approaches is very important for the management of DFUs.
The combined use of surgical debridement and maggot therapy is a safe and effective method for improving diabetic foot ulcers and preventing amputation.
糖尿病足溃疡(DFU)是糖尿病的主要并发症之一,可能导致肢体截肢。截肢会对个人生活产生深远的身体和心理影响。如今,预防肢体截肢和治疗糖尿病足溃疡被视为主要的健康挑战。
本病例报告的是一位72岁女性,患有2型糖尿病20年,右脚后跟和脚底分别有大小为6×5厘米和3×3厘米的不对称浅表糖尿病足溃疡。溃疡感染了金黄色葡萄球菌和大肠杆菌。该患者曾多次住院接受治疗,但溃疡不仅未愈合,反而大幅扩大,导致足部截肢风险大大增加。患者被转至我们的伤口护理服务部门。在进行了一次手术清创后,患者使用无菌丝光绿蝇进行了十次蛆虫疗法(每两天一次)。大约六个月后,患者的糖尿病足溃疡完全愈合。
糖尿病足溃疡会影响患者的生活质量,并导致感染、败血症、截肢,甚至患者死亡。因此,采用有效的治疗方法对于糖尿病足溃疡的管理非常重要。
手术清创和蛆虫疗法联合使用是改善糖尿病足溃疡和预防截肢的一种安全有效的方法。