Maggot Therapy for Healing of Pressure Ulcers Post SCI

Author Year
Country
PEDro Score
Research Design
Total Sample Size

Methods Outcome
Pulsed Lavage

Ho et al. 2012
USA
PEDro=5
RCT
N=28

Population: People with SCI and stage III and IV pelvic pressure ulcers.

Intervention: Daily low-pressure pulsatile lavage treatment with 1 L of normal saline at 11 psi of pressure was applied to the treatment group along with standard dressing changes. The control group received only sham treatment and standard dressing changes.

Outcome Measures: Linear and volume measurements of pressure ulcer dimensions were obtained 1x/wk for 3 wk.

  1. Pulsatile lavage enhanced stage III and IV pelvic pressure ulcer healing rates in people with SCI relative to standard pressure ulcer treatment alone.

Bogie et al. 2013
USA
Observational
N=28

Population: Mean age=55 yr; Gender: males=28, females=0; Level of Injury: paraplegic=12, tetraplegic=12; Wound status: grade III ulcers=8, grade IV ulcers=IV.

Intervention: Chart reviews of patients who were treated by pulsatile lavage therapy.

Outcome Measures: Adverse effects, treatment discontinuation and injuries to clinical care providers.

  1. No adverse events for patients or care providers (mean therapy duration 46 days).
  2. Treatment was temporarily discontinued in one patient due to mild bleeding from wound and resumed six days later.
  3. Treatment discontinued for two patients due to a fever in one patient and rapid improvement in wound size in another.
Maggot Therapy

Wang et al. 2010
China
Observational
N=25

Population: Patients with diabetic foot ulcers and 18 patients with pressure ulcers after SCI.

Intervention: Maggot therapy or traditional dressing

Outcome Measures: Changes in the lesions were observed and bacterial cultures tested.

  1. Maggot therapy is a safe and effective method for treating chronically infected lesions
  2. All ulcers healed completely. The times taken to achieve bacterial negativity, granulation and healing of lesions were all significantly shorter in the maggot therapy group than in the control group, both for diabetic foot ulcers (p< 0.05) and pressure ulcers (p< 0.05).

Sherman et al. 1995
USA
Prospective Control Trial
N=8

Population: Mean age=44-68 yr; Gender: males=81; Level of injury: paraplegia=7, tetraplegia=1; Ulcer stages: III and IV.

Treatment: 3-4 wks of conventional therapy preceded maggot placement under porous sterile dressings, for 48-72 hr cycles. Sodium hypochorite, normal saline or wet-to-dry gauze dressings were applied every 8 hours in between maggot cycles.

Outcome Measures: Healing of pressure ulcer; wound area size.

  1. Maggot therapy decreased pressure ulcer surface area by 22% per wk (p<0.001).
  2. No adverse consequences of treatment were noted.
Silicone Moulding

Erba et al. 2010
Switzerland
Post-Test
N=10

Population: Mean age=42 yr; Gender: males=6, females=4; Level of injury: paraplegic=10; Wound status: grade IV ulcer=10.

Intervention: Injection of fluid silicone. Silicone moulding to facilitate debridgement.

Outcome Measures: Radical en bloc debridgement achievement, complications and recurrences.

  1. No complications or recurrences occurred (mean follow-up 25 mo).
  2. In all patients debridgement was performed en blooc without perforation into the decubital cavity and without additional excisions needed.
  3. No postoperative complications occurred.
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