It is considered that up to 25 percent of diabetic patients can be affected with ulcers in the lower limbs. This is because these patients can suffer nerve damage and loss of sensation in the feet, preventing them from feeling cuts, blisters or sores; which in turn can cause serious injuries and infections.

There are several medical alternatives to treat diabetic foot injuries and one of them is a wound cleaning technique that uses medical grade larvae of Lucilia sericata (common green cottle fly), produced in a sterile way for surgical use in a specialized laboratory.

The effectiveness of the so-called larval-therapy at the Doctor Manuel Gea González General Hospital, in Mexico City, is 85 to 100 percent, says Dr. José Contreras Ruiz, head of the Wounds and Stoma Clinic section of the division of Dermatology of the public health institution.

This larva, the specialist explains, as it moves inside the wound, it releases dead tissue and the proteolytic enzymes it releases make it easier to remove by doctors or nurses. They are selective, not damaging the good tissue, and take 24 to 48 hours to clean the infected wound.

Dr. Contreras Ruiz reports that 20 percent of the consultations of diabetic patients in this hospital are due to diabetic foot, which implies the intervention of several specialists for a comprehensive treatment, where larval-therapy is key to achieve the patient’s healing.

“Diabetic foot has a vascular, infectious component of damaged or dead tissue and in glucose control. Therefore, interdisciplinary management is essential and implies having control of the patient’s blood sugar level. An infectologist must perform the review and analysis of the bacteria in the wound so that the larvae eat everything rotten and counteract the damage caused by the bacteria.

“In many cases they are patients in wheelchairs or [persons] who do not make their normal life for ulcers, there is depression and couples get angry with them. Imagine being sleeping in the same bed with someone who has a sore open for so many years. Once we improve them and make them heal, it greatly improves the quality of life,” says Dr. Contreras Ruiz.

However, there are cases where patients arrive with an advanced infected wound or with a large amount of pus and dead tissue that the larvae fail to eat, because the infection progresses faster. So, it is required surgical management before using the larvae.

Contreras Ruiz says the larvae used, come from a controlled process in the laboratory. It should be noted that this hospital was the first in Mexico and Latin America to apply this type of therapy.

The technique, standardized worldwide and approved by the FDA (Food and Drug Administration) in the United States, is also indicated in wounds of many types, such as venous or varicose ulcers, pressure injuries or bedsores, in surgical wounds that they have not healed or in any chronic type where there is dead tissue.

 

Source: Agencia ID