Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May:82:105931.
doi: 10.1016/j.ijscr.2021.105931. Epub 2021 Apr 29.

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

Naser Parizad  1 , Kazem Hajimohammadi  2 , Rasoul Goli  3
Affiliations

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

Naser Parizad et al. Int J Surg Case Rep. 2021 May.

Abstract

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.

Keywords: Amputation; Debridement; Diabetic foot; Larva; Negative-pressure wound therapy; Silver.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Diabetic foot ulcer before starting the combination therapy.
Fig. 2
Fig. 2
Maggots of Lucilia sericata in diabetic foot ulcer.
Fig. 5
Fig. 5
Diabetic foot ulcer of the patient after combination therapy.
Fig. 3
Fig. 3
Diabetic foot ulcer after maggot therapy.
Fig. 4
Fig. 4
NPWT applied following maggot therapy.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Armstrong D.G., Boulton A.J., Bus S.A. Diabetic foot ulcers and their recurrence. N. Engl. J. Med. 2017;376(24):2367–2375. doi: 10.1056/NEJMra1615439. - DOI - PubMed
    1. Hurlow J.J., Humphreys G.J., Bowling F.L., McBain A.J. Diabetic foot infection: a critical complication. Int. Wound J. 2018;15(5):814–821. doi: 10.1111/iwj.12932. - DOI - PMC - PubMed
    1. Lipsky B.A., Berendt A.R., Cornia P.B., Pile J.C., Peters E.J., Armstrong D.G. Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin. Infect. Dis. 2012;2012(54(12)) (e132-73. DOI: 10.1093/cid/cis346) - PubMed
    1. Adeghate J., Nurulain S., Tekes K., Fehér E., Kalász H., Adeghate E. Novel biological therapies for the treatment of diabetic foot ulcers. Expert. Opin. Biol. Ther. 2017;17(8):979–987. doi: 10.1080/14712598.2017.1333596. - DOI - PubMed
    1. Hajmohammadi K., Zabihi R.E., Akbarzadeh K., Parizad N. Using a combination therapy to combat scalp necrosis: a case report. J. Med. Case Rep. 2020;14(1):1–5. doi: 10.1186/s13256-020-02450-5. - DOI - PMC - PubMed