The incidence of diabetic foot ulcer in Malaysia is increasing as the population ages. Diabetic foot ulcer is one of the major complications of long-standing diabetes mellitus, which may lead to amputation if left untreated and/or undertreated. Management of the diabetic foot requires a thorough knowledge of the major risk factors for amputation, frequent routine evaluation and meticulous preventive maintenance. The most common risk factors for ulcer formation include diabetic neuropathy, structural foot deformity and peripheral arterial occlusive disease. There are several therapies used in treating diabetic foot ulcer, including maggot debridement therapy. Maggot therapy is a type of biological therapy involving the introduction of live, disinfected maggots (fly larvae) into non-healing skin and soft tissue wounds of a human for the purpose of cleaning out the necrotic tissue or slough within a wound, disinfecting the wound, at the same time promoting granulation tissue and epithelization. A 30-patient trial was conducted in the Wound Care Unit at Kuala Lumpur Hospital. Maggot debridement therapy (MDT) was used to debride the wounds. The percentage of wound healing was measured. Pain score was assessed and any side effects or complications such as myiasis and bleeding was documented.
All wounds showed reduction in slough and necrotic tissue with wound healing as assessed by area measurements. Pain reduction was noted and there were no untoward effects.
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