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蛆虫疗法、藻酸盐敷料和手术锐性清创术:挽救无反应性糖尿病足溃疡的独特途径。

Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer.

作者信息

Hajimohammadi Kazem, Parizad Naser, Bagheri Mojde, Faraji Navid, Goli Rasoul

机构信息

Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran.

Patient Safety Research Center, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran.

出版信息

Int J Surg Case Rep. 2023 Oct;111:108907. doi: 10.1016/j.ijscr.2023.108907. Epub 2023 Oct 4.

Abstract

INTRODUCTION AND IMPORTANCE

Diabetic foot ulcers are a severe complication of diabetes mellitus, affecting a significant proportion of the diabetic population. In some cases, ulcer progression and infection can lead to the need for amputation.

CASE PRESENTATION

An 84-year-old male with a history of poorly controlled type 2 DM and HTN presented with an infected DFU on the plantar aspect of his right foot. This case report illustrates the successful management of an 84-year-old patient with a DFU amputation candidate, emphasizing the effectiveness of a combined treatment approach.

CLINICAL DISCUSSION

Conventional treatment options, including antibiotic therapy, often fail to provide adequate healing in these high-risk patients. Alternative approaches, such as maggot therapy, which involves the application of sterile maggots to the wound bed, have shown promising results.

CONCLUSION

This case highlights the potential therapeutic benefits and clinical efficacy of such a combined treatment approach, particularly in challenging cases with limited response to conventional therapies. Further studies and randomized trials may be warranted to support the incorporation of this therapy combination into clinical practice guidelines for DFU management.

摘要

引言与重要性

糖尿病足溃疡是糖尿病的一种严重并发症,影响着相当一部分糖尿病患者。在某些情况下,溃疡进展和感染可能导致截肢。

病例介绍

一名84岁男性,有2型糖尿病和高血压病史且控制不佳,其右足跖面出现感染性糖尿病足溃疡。本病例报告说明了对一名有截肢风险的84岁糖尿病足溃疡患者的成功治疗,强调了联合治疗方法的有效性。

临床讨论

包括抗生素治疗在内的传统治疗方法,往往无法使这些高危患者实现充分愈合。诸如蛆虫疗法等替代方法,即将无菌蛆虫应用于伤口床,已显示出有前景的结果。

结论

本病例突出了这种联合治疗方法的潜在治疗益处和临床疗效,尤其是在对传统疗法反应有限的挑战性病例中。可能需要进一步的研究和随机试验,以支持将这种治疗组合纳入糖尿病足溃疡管理的临床实践指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0d/10570003/4d903e72643d/gr1.jpg

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