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Item #2
Maggots
Best in Debriding Nonhealing Ulcers
Maggot
therapy is more successful in debriding nonhealing ulcers than is
continued conventional care.
That,
according to the results of a retrospective review published in the
February issue of Diabetes Care. The investigators suggest that
this therapy is worthy of further research to properly define its
role.
"Over
the past few years, there has been a resurgence in the use of maggot
therapy, even though its optimal role has not been clearly
defined," write Ronald A. Sherman, MD, MSC, and colleagues from
the Veterans Affairs Medical Center in Long Beach and the University
of California, Irvine. "Large prospective clinical trials have
not been conducted for maggot therapy, and there are no commercial
backers to support such studies."
In
the study, of 20 nonhealing ulcers in 18 patients, six wounds were
treated with conventional therapy, six with maggot therapy, and eight
with conventional therapy followed by maggot therapy.
Although
conventional therapy failed to achieve any significant debridement
during the first 14 days, maggot therapy allowed necrotic tissue to
decrease by an average of 4.1 cm2
during the same time frame (P = .02). After five weeks of
therapy, necrotic tissue still covered more than 33% of the surface of
conventionally treated wounds, but maggot-treated wounds were
completely debrided after four weeks of therapy (P = .001).
Growth of granulation tissue was faster and wound healing rates were
also better with maggot therapy.
"Maggot
therapy was more effective and efficient in debriding nonhealing foot
and leg ulcers in male diabetic veterans than was continued
conventional care," the authors write. "In addition to
issues of efficacy and safety, future studies also must address the
cost-effectiveness of maggot debridement therapy and conditions in
which [it] is likely to be futile."
Diabetes Care. 2003;26:446-451
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FACT
The
average CRP reading in this country is 1.5. The risk is dramatically
higher when the levels hit 3, studies show. CRP
tests should be expressed as milligrams per Liter (mg/L) with
concentrations of less than 1.0 mg/L defined as low risk, 1.0-3.0 mg/L
as average risk and concentrations higher than 3.0 mg/L defined as
high risk.
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Let
your Patients Enjoy low carb chocolates with no sugar and 1gm of
carbohydrate:
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Here
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