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- Title
Maggot debridement therapy and complementary wound care: a case series from Nigeria.
- Authors
Yusuf, Mustapha Ahmed; Ibrahim, Bashir Mohammed; Oyebanji, Azeez-Akande; Abubakar, Firdausi; Ibrahim, Mustapha; Ibrahim Jalo, Rabiu; Aminu, Aliyu; Akbarzadeh, Kamran; Azam, Malekian; Sheshe, Abdulrahman Abba; Ganiyu, Oseni Oyediran; Abubakar, Mohammed Kabir; Salisu, Waliu Jahula; Kordshouli, Razieh Shabani; Adamu, Almukhtar Yahuza; Takalmawa, Hamisu; Daneji, Isa; Aliyu, Mansur; Ibrahim, Muhammad Getso; Kabuga, Auwal Idris
- Abstract
Objective: Maggot debridement therapy (MDT) is an emerging procedure involving the application of sterile maggots of the Dipteran species (commonly Lucilia sericata) 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 Lucilia sericata 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 56cm2. 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 Staphylococcus aureus was the predominant isolate in 17 wounds (56.7%) while Pseudomonas aeruginosa and Streptococcus pyogenes were predominant in five wounds (16.7%) each. Only four (13.3%) wound cultures yielded bacterial growth after MDT, all Staphylococcus aureus. 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.
- Subjects
NIGERIA; WOUND healing; TRAUMATOLOGY diagnosis; DEBRIDEMENT; FOOT ulcers; RESEARCH methodology; DIABETIC foot; WOUND infections; TIME; MAGGOT therapy; STREPTOCOCCUS; GANGRENE; TREATMENT effectiveness; SURGICAL site infections; DESCRIPTIVE statistics; STAPHYLOCOCCUS aureus; PSEUDOMONAS; WOUND care; NECROTIZING fasciitis
- Publication
Journal of Wound Care, 2022, Vol 31, Issue 11, p996
- ISSN
0969-0700
- Publication type
Article
- DOI
10.12968/jowc.2022.31.11.996