Using Maggot Debridement Therapy to Remove Main Bacteria Species from Diabetic Foot Ulcers In Tehran, Northern Iran

Introduction: Diabetic foot ulcer is a major long time complication of diabetes mellitus. Diabetics have a 15% higher risk for amputation than the general population.Objectives:This study was aimed at using medical maggot for removal of main bacteriapathogens in diabetic foot ulcers.Materials and method: A randomized case-control clinical trial method was used in this study. A total of fifty (50) clients with diabetic foot (Wagener’s grade II or III) were randomly selected. The maggot debridement therapy (MDT) was included into the routing treatment protocol of the wounds of those categorize as case group, whereas wounds of thosecategorized as control group were treated with standard healing protocol. Larvae of Lucilia sericata sterilized and used as the MDT agent. The application of MDT on the wound was done at an interval of 48 hours. Wound swab microscopy, culture and sensitivity for bacteria isolation and identification was done before MDT and after washing the larvae out in both the case and control groups.Results: The reduction of the infected cases with this bacteria didn’t show significant difference after 2 days (p=0.1). But after 4 days, the second use of larvae, the reduction was significantly differed in case group (p=0.002). However there wasn’t any reduction in the cases of control group during this period of treatment.Conclusion: Several mechanisms have been mentioned for the antimicrobial activity and effectiveness of MDT. Results of the present study demonstrate the ability of MDT to remove main bacterial species either in infected cases with one organism P, aeruginosa or S. aureus, or in infection with both pathogens.