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

Autor:	Yusuf MA; Department of Medical Microbiology and Parasitology, Bayero University, Kano, Nigeria., Ibrahim BM; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Abubakar F; Family Medicine Department, Aminu Kano Teaching Hospital, Kano, Nigeria., Ibrahim M; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Sheshe AA; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Abubakar MK; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Aji SA; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Gbadamasi KA; National Orthopaedic Hospital Dala, Kano, Nigeria., Busayo JK; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Sallau SB; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Ridwan BA; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Uloko AE; Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Gezawa ID; Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Ramalan M; Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Sidi K; Department of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Abdullahi S; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Adamu KM; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Bello N; Department of Otorhinolaryngology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Muhammad A; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Mukhtar R; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria., Aina D; Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
Jazyk:	angličtina
Zdroj:	Journal of wound care [J Wound Care] 2024 Feb 01; Vol. 33 (Sup2), pp. S24-S30.
DOI:	10.12968/jowc.2024.33.Sup2.S24
Abstrakt:	Objective: Approximately 13% of people living with diabetes develop one or more ulcers during the course of the disease, and diabetic foot ulcer (DFU) is responsible for >60% of lower limb amputations worldwide. This case series aimed to demonstrate the effectiveness of medical-grade maggots on DFUs in promoting wound healing and reducing related hospital stays in northern Nigeria. Method: Maggot debridement therapy (MDT) was applied to the DFUs of patients who consented to this treatment between January-August 2021 at the Orthopaedic Unit of the Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Sterile first instar larvae of Lucilia sericata were obtained indigenously and applied using the confinement (free-range) method under aseptic procedure. Results: A total of 15 patients with DFUs of Wagner classification grades III (33.3%) and IV (66.7%), were seen and documented. The patients included 10 (66.7%) females and five (33.3%) males, giving a female:male ratio of 2:1. The mean age (±standard deviation) of the respondents was 51.6±10.8 years. The surface area of the wounds ranged from 24-140cm 2 , with a median value of 75cm 2 . Among the patients, 60% had two cycles of MDT, with a median duration of five days. Most of the wounds (53.3%) were debrided within five days; 13.3% (two wounds) took seven days to be fully debrided. A paired sample t-test showed a statistically significant association between wound surface area and therapy duration (t=8.0; p=0.000) and between wound surface area and cycles of therapy (t=8.3; p=0.000). Before maggot application, 14 (93.3%) DFUs were completely (100%) covered with slough and only one (6.7%) was 95% covered with slough. After maggot application, 10 (66.7%) wounds were completely debrided while five (33.3%) wounds required bedside surgical debridement to achieve complete debridement. A paired sample t-test showed statistically significant difference between the pre- and post-MDT slough covering the wounds (t=45.1; p=0.000). Conclusion: In this case series, MDT was successfully used in the debridement of DFUs, which facilitated the healing process with an encouraging clinical outcome.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu