ACTA FAC MED NAISS 2020;37(4):387-395

Original article

UDC: 616.379-008.64:611.986]:616-08

DOI: 10.5937/afmnai2004387D

A New Approach to Maggot Therapy for Healing
of Diabetic Foot Ulcers

Omid Dehghan¹, Seyed Mehdi Tabaie², Javad Rafinejad¹, Mehrangiz Toutonnchy²,
Amir Tiyuri³, Kamran Akbarzadeh⁴, Seyed Farzad Motevalli Haghi⁵

¹Department of Medical Entomology and Vector Control, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
²Department of Dermatology, Medical Laser Research Center, ACECR, Tehran, Iran
³Department of Epidemiology, School of Health, Iran University of Medical Sciences, Tehran, Iran
⁴Department of Medical Entomology and Vector Control, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
⁵Department of Medical Entomology and Vector Control, Health Sciences Research Center, Addiction Institute,
Faculty of Health, Mazandaran University of Medical Sciences, Mazandaran (Sari), Iran

SUMMARY

                  The use of maggot therapy (MT) is proving effective in the treatment of complicated diabetic foot ulcers (DFUs). Most of the previous studies have focused on the comparison of MT and routine treatment approaches for the management of DFUs. The aim of this study was to add MT to routine treatment line of DFUs as a new approach. In this study, the principal expectation from MT method was to prepare wound bed for continuation of the treatment with other measures. This study was designed as a before-after observational study. Twenty-five out of the initial 47 volunteers who presented with DFUs to our wound clinic were included in our study. In the present study, a total of 27 DFU cases were managed with maggot therapy using the Karaj Strain of Lucilia sericata (L. sericata). MT was added to routine treatments as a complementary therapy. Surface areas of the necrotic tissues and granulation tissues over time were calculated. Satisfaction of patients and physicians was evaluated with a questionnaire. There was a significant reduction in the surface area of necrotic tissues and increase in the surface area of granulation tissues (p < 0.0001) as early as four days after the initiation of maggot therapy. After adjusting for confounding variables, statistical analysis confirmed a significant reduction in the size of necrotic tissues and increase in granulation tissues formation (p < 0.001). About 96.3% of the physicians and patients involved in our study were satisfied with the results of the treatment. The time for significant reduction of the size of necrotic tissues was less than in similar studies. This study confirmed that effective, faster and satisfactory results can be achieved when MT is added to routine treatments as a complementary therapy for healing DFUs. This approach can be introduced as a new treatment modality for healing DFUs with high rate success.

Key words: maggot therapy, diabetic foot ulcers, Lucilia sericata