Experiencia de terapia larval en pacientes con úlceras crónicas

Abstract

MAGGOT THERAPY IN PATIENTS WITH CHRONIC SKIN ULCERS The technique of maggot therapy was applied for the first time in Chile in an attempt to duplicate beneficial results of this method as reported in the literature. Microbiologically sterile fly larvae were used to clean five ulcerative lesions (three sacral, one trocantral, and one diabetic foot) in four patients in the Surgical Service of the Valdivia Regional Hospital. The selected patients signed informed consent release papers permitting the therapy. The sterile larvae were obtained from the eggs of Lucilia sericata flies which had been treated with 0.5% sodium hypochlorite followed by 10% formalin, with sterility proved by negative results of inoculations of eggs onto blood agar and into tryptose broth. The larvae were deposited onto ulcers at 5-10 larvae per cm 2 of surface, protecting adjacent healthy skin with an adhesive tape shield. Escape of the larvae was prevented by overlaying the preparation with fine nylon screen. The exudate from the preparation was absorbed by gauze pads which were changed 2-3 times a day. The ulcers treated were totally cleaned after 1-6 applications of larvae, and odors disappeared after the first larval application in all patients. There was some escape of larvae in all patients in the initial stages of the treatment. Only one patient experienced a tickling sensation due to the larvae. The method proposed here may be of great use for the cleaning of chronic ulcers in patients who show no improvement from routine daily treatment of the ulcers.