Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers are a severe complication of diabetes mellitus, affecting a significant proportion of the diabetic population. In some cases, ulcer progression and infection can lead to the need for amputation. CASE PRESENTATION: An 84-year-old male with a history of poorly controlled type 2 DM and HTN presented with an infected DFU on the plantar aspect of his right foot. This case report illustrates the successful management of an 84-year-old patient with a DFU amputation candidate, emphasizing the effectiveness of a combined treatment approach. CLINICAL DISCUSSION: Conventional treatment options, including antibiotic therapy, often fail to provide adequate healing in these high-risk patients. Alternative approaches, such as maggot therapy, which involves the application of sterile maggots to the wound bed, have shown promising results. CONCLUSION: This case highlights the potential therapeutic benefits and clinical efficacy of such a combined treatment approach, particularly in challenging cases with limited response to conventional therapies. Further studies and randomized trials may be warranted to support the incorporation of this therapy combination into clinical practice guidelines for DFU management.

Surgical debridement and maggot debridement therapy (MDT) bring the light of hope to patients with diabetic foot ulcers (DFUs): A case report.

INTRODUCTION AND IMPORTANCE: Management of diabetic foot ulcers (DFUs), one of the complications of diabetes mellitus, can lead to death and amputation, and it is one of the most critical challenges for the patients and their families. CASE PRESENTATION: The present case report concerns a 72-year-old man with a 5-year history of uncontrolled type 2 diabetes mellitus. The patient had antibiotic-resistant DFUs on two phalanges of his left foot, which were completely gangrenous, and a superficial ulcer of 1 × 1 cm under his left foot. Despite the routine DFU care, the phalanges of his DFU were amputated. The patient was moved to our wound management team. DFU was treated and managed using surgical debridement and maggot debridement therapy. Ten sessions of Maggot Debridement Therapy (MDT) were conducted (one therapy session every 48 h). After three months, the patient's DFUs healed, and he was discharged from our service in good condition. CLINICAL DISCUSSION: DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs. CONCLUSION: Using surgical debridement and MDT is a safe and effective approach to facilitate the healing of DFUs.

Treating surgical site infection by honey antibacterial wound dressing in a neonate: a case report.

Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.

Saving diabetic foot ulcers from amputation by surgical debridement and maggot therapy: A case report.

INTRODUCTION AND IMPORTANCE: A diabetic foot ulcer (DFU) is one of the major diabetes complications that may lead to limb amputation. Amputation can have profound physical and psychological effects on an individual's life. Nowadays, the prevention of limb amputation and treatment of DFUs are known as the major health challenges. CASE PRESENTATION: The present case report is of a 72-year-old woman with a 20-year history of type 2 diabetes who has had asymmetrical and superficial DFUs with sizes of 6 × 5 cm and 3 × 3 cm on the heel and the sole of the right foot, respectively. The ulcers were infected by S. aureus and E. coli. The patient had been hospitalized several times for receiving treatment, and not only the ulcers had not been healed, but also they had considerably extended so that the risk of foot amputation had been greatly increased. The patient was transferred to our wound care service. After conducting one session of surgical debridement, the patient underwent ten sessions of maggot therapy (one session every two days) using sterile Lucilia sericata. After about six months, the patient's DFUs were completely healed. CLINICAL DISCUSSION: DFU can affect a patient's quality of life and lead to infection, sepsis, amputation, and even patient death. Therefore, using effective treatment approaches is very important for the management of DFUs. CONCLUSION: The combined use of surgical debridement and maggot therapy is a safe and effective method for improving diabetic foot ulcers and preventing amputation.

Surgical debridement, maggot therapy, negative pressure wound therapy, and silver foam dressing revive hope for patients with diabetic foot ulcer: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs), as one of the most debilitating complications of diabetes, can lead to amputation. Treatment and management of d DFUs are among the most critical challenges for the patients and their families. CASE PRESENTATION: The present case report is of a 63-year-old man with a 5-year history of uncontrolled type 2 diabetes who has had DFU for the past three years on three sites of the left external ankle in the form of two deep circular ulcers with sizes of 6 × 4 cm and 6 × 8 cm, the sole as a superficial ulcer with a size of 6 × 3 cm, and the left heel as a deep skin groove. Moreover, the left hallux was completely gangrenous. The patient's ulcers were infected with Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa. The patient was transferred to our wound management team. DFU was treated and managed using a combination of surgical debridement, maggot therapy, the Negative Pressure Wound Therapy (NPWT), and silver foam dressing. After three months and ten days, the patient's ulcers completely healed, and he was discharged from our service with the excellent and stable condition. CLINICAL DISCUSSION: DFUs are caused by various pathological mechanisms, the monotherapy strategy would lead to a very low level of recovery. Therefore, DFU management requires multimodal care and interdisciplinary treatment. CONCLUSION: Based on the present case report study's clinical results, wound-care teams can use the combination therapy applied in this case report to treat refractory DFU.

Treating post-renal transplant surgical site infection with combination therapy: a case study.

Surgical site infection (SSI) is one of the most common and debilitating complications of surgery. The risk of SSI rises if the patient has underlying health-related risk factors. This article reports on the complicated case of 61-year-old female with a history of obesity and diabetes. She was diagnosed with end-stage renal disease (ESRD) and had been receiving haemodialysis since 2012. She underwent a kidney transplant and developed a multidrug-resistant Pseudomonas aeruginosa SSI following surgery. She experienced delayed wound healing with a partially dehisced incision. Despite conventional wound care, there was no progress in wound healing. The authors combined sharp debridement, irrigation and antibiotic therapy with a silver-containing antimicrobial dressing for 1 month. Her SSI improved significantly and she returned to theatre for wound closure. The patient recovered well and was discharged from the hospital after suture removal. Wound care professionals can use combination therapies to manage SSIs effectively and reduce patient and healthcare costs.

NPWT: a gate of hope for patients with diabetic foot ulcers.

Non-healing diabetic foot ulcers are a common and costly complication of type 2 diabetes and can result in lower extremity amputation. This case study concerns a 51-year-old man with a 17-year history of uncontrolled type 2 diabetes. He had developed a deep ulcer to the calcaneus of his left foot, which was 12x7 cm in size and infected with multi-drug-resistant Staphylococcus aureus. He was admitted to hospital for the non-healing diabetic foot ulcer and uncontrollable fever and was a candidate for amputation. He was treated with wound irrigation and debridement as well as negative-pressure wound therapy and antibiotic treatment. This strategy was effective and the wound size reduced progressively. The patient recovered well. Medical and wound care teams who deal with non-healing diabetic foot ulcers can benefit from a strategy of combination therapy.