TY - JOUR
T1 - Clinical study of Maggot therapy for Fournier's gangrene
AU - Fonseca-Muñoz, Alicia
AU - Sarmiento-Jiménez, Hugo E.
AU - Pérez-Pacheco, Rafael
AU - Thyssen, Patricia J.
AU - Sherman, Ronald A.
N1 - Publisher Copyright:
© 2020 Medicalhelplines.com Inc and John Wiley & Sons Ltd
PY - 2020/12
Y1 - 2020/12
N2 - Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture-directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.
AB - Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture-directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.
KW - Fournier's gangrene
KW - Lucilia sericata
KW - biotherapy
KW - clinical study
KW - maggot therapy
UR - http://www.scopus.com/inward/record.url?scp=85088276946&partnerID=8YFLogxK
U2 - 10.1111/iwj.13444
DO - 10.1111/iwj.13444
M3 - Artículo
C2 - 32691532
AN - SCOPUS:85088276946
SN - 1742-4801
VL - 17
SP - 1642
EP - 1649
JO - International Wound Journal
JF - International Wound Journal
IS - 6
ER -