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Oral Abstracts (Session 5 of 5)
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Moderator: David Keast, MSc, MD, CCFP, FCFP (Presentation 36.2) Maggot therapy and infection control in venous ulcers: a comparative study José Contreras-Ruiz, MD; Sara Arroyo-Escalante; Adan Fuentes-Suarez, MD, Dr. Manuel Gea Gonzalez General Hospital, Mexico City, Mexico; Judith Dominguez-Cherit, MD; Cristina Sosa-de-Martinez, MS, National Institute of Pediatrics, Mexico City, Mexico; Ernesto Maravilla-Franco, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico Abstract: Maggot therapy (MT) has been reported as faster, less painful, and more selective than other methods of debridement. Apparently, the use of larvae to debride wounds has the added benefit of killing the bacteria in the wound bed. We underwent a controlled trial to assess whether or not larval debridement therapy was more effective than conventional care. Nineteen patients were randomized to 2 groups (either MT and compression, conventional treatment with curettage, topical silver sulfadiazine, or proper dressing and compression). Clinical evaluations were performed weekly by a blinded observer for 1 month to assess for wound size, bed appearance, exudate amount, pain, and anxiety. Bacterial burden was evaluated using quantitative biopsy cultures. When the 2 groups were compared, MT showed no difference to conventional treatment regarding wound size, healing rate, wound bed appearance, or pain. The MT-treated group had higher exudate amounts and produced more anxiety and odor. Bacterial counts were significantly lower for MT. We suggest that MT did in fact decrease total bacterial burden (larger studies are needed to confirm this observation) and is as effective as the standard surgical debridement and wound care for promoting healing. Pain was perceived as similar in both groups. |
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