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蛆虫清创疗法与辅助性伤口护理:来自尼日利亚的一组病例。

Maggot debridement therapy and complementary wound care: a case series from Nigeria.

机构信息

Department of Medical Microbiology and Parasitology, Bayero University, Kano, Nigeria.

Microbiology Department, Aminu Kano Teaching Hospital, Kano, Nigeria.

出版信息

J Wound Care. 2022 Nov 2;31(11):996-1005. doi: 10.12968/jowc.2022.31.11.996.


DOI:10.12968/jowc.2022.31.11.996
PMID:36367805
Abstract

OBJECTIVE: Maggot debridement therapy (MDT) is an emerging procedure involving the application of sterile maggots of the Dipteran species (commonly ) to effect debridement, disinfection and promote healing in wounds not responding to antimicrobial therapy. Data on MDT in sub-Saharan Africa (including Nigeria) are scarce. This study aimed to use medicinal grade maggots as a complementary method to debride hard-to-heal necrotic ulcers and thereby promote wound healing. METHOD: In this descriptive study, we reported on the first group of patients who had MDT at Aminu Kano Teaching Hospital (AKTH), a tertiary hospital in northern Nigeria. The first instar larvae of were applied using the confinement (free-range) maggot therapy dressing method under aseptic conditions. RESULTS: Diabetic foot ulcer (DFU) grade III-IV constituted more than half of the wounds (53.3%), followed by necrotising fasciitis (30%), and post-traumatic wound infection (10%). Others (6.7%, included pyomyositis, surgical site infection and post traumatic wound infection). The median surface area of the wounds was 56cm. Of the 30 patients, half (50%) had two MDT cycles with a median time of four days. Of the wounds, 22 (73%) were completely debrided using maggots alone while eight (27%) achieved complete debridement together with surgical debridement. Wound culture pre-MDT yielded bacterial growth for all the patients and was the predominant isolate in 17 wounds (56.7%) while and were predominant in five wounds (16.7%) each. Only four (13.3%) wound cultures yielded bacterial growth after MDT, all . CONCLUSION: A good prognosis was achieved post-MDT for various wounds. MDT effectively debrides and significantly disinfects wounds involving different anatomical sites, thus enhancing wound healing and recovery. MDT is recommended in such wounds.

摘要

目的:蛆虫清创疗法(MDT)是一种新兴的程序,涉及应用无菌蝇科(通常)的幼虫来清创、消毒,并促进对抗生素治疗无反应的伤口愈合。关于撒哈拉以南非洲(包括尼日利亚)MDT 的数据很少。本研究旨在使用药用级蛆虫作为一种辅助方法来清创难以愈合的坏死性溃疡,从而促进伤口愈合。

方法:在这项描述性研究中,我们报告了在尼日利亚北部的一家三级医院 Aminu Kano 教学医院(AKTH)接受 MDT 的第一批患者。在无菌条件下,使用隔离(自由放养)蛆虫治疗敷料方法应用第一龄幼虫。

结果:糖尿病足溃疡(DFU)III-IV 级占伤口的一半以上(53.3%),其次是坏死性筋膜炎(30%)和创伤后感染(10%)。其他(6.7%,包括肌脓肿、手术部位感染和创伤后感染)。伤口的平均表面积为 56cm。在 30 名患者中,有一半(50%)接受了两个 MDT 周期,平均时间为四天。在所有的伤口中,22 个(73%)只用蛆虫就完全清创了,8 个(27%)与手术清创一起完全清创。MDT 前的伤口培养物显示所有患者的细菌生长,17 个伤口(56.7%)中 为主要分离株,5 个伤口(16.7%)中 为主要分离株,每个 5 个伤口(16.7%)。MDT 后仅 4 个(13.3%)伤口培养物有细菌生长,均为 。

结论:MDT 后,各种伤口均取得良好预后。MDT 有效地清创并显著消毒涉及不同解剖部位的伤口,从而促进伤口愈合和恢复。建议在这些伤口中使用 MDT。

相似文献

[1]
Maggot debridement therapy and complementary wound care: a case series from Nigeria.

J Wound Care. 2022-11-2

[2]
The role of medical-grade maggots in facilitating healing of diabetic foot ulcers in Kano, northern Nigeria: a case series.

J Wound Care. 2024-2-1

[3]
The influence of maggot debridement therapy on the bacterial flora of hard-to-heal wounds.

J Wound Care. 2024-10-2

[4]
Changing attitudes toward maggot debridement therapy in wound treatment: a review and discussion.

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[5]
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[6]
Towards next generation maggot debridement therapy: transgenic Lucilia sericata larvae that produce and secrete a human growth factor.

BMC Biotechnol. 2016-3-22

[7]
[Mechanism of maggot debridement therapy in promoting wound angiogenesis in patients with diabetic foot ulcer].

Zhonghua Shao Shang Za Zhi. 2020-11-20

[8]
Efficacy of Maggot Debridement Therapy on Refractory Atypical Diabetic Foot Ulcers: An Open-Label Study.

Int J Low Extrem Wounds. 2021-12

[9]
Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers.

J Wound Care. 2007-10

[10]
Maggot debridement therapy to treat hard-to-heal diabetic foot ulcers: a single-centre study.

J Wound Care. 2021-12-1

引用本文的文献

[1]
Burn Debridment - Approach and Review.

Curr Health Sci J. 2025

[2]
Expanding access to maggot containment dressings through redesign and innovation.

Int Wound J. 2025-1

[3]
Not all maggots are created equal; not all maggots are therapeutic.

Clin Case Rep. 2024-7-17

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