Efficacy of Maggot Debridement Therapy on Refractory Atypical Diabetic Foot Ulcers, an Open Label Study

Introduction: Atypical or refractory diabetic foot ulcers (DFUs) are still a major health problem. Maggot debridement therapy (MDT) by larva of Lucilia sericata is an ancient and also modern option for wound healing. It works by debridement, stimulation of wound healing and disinfection. In this study we tried to evaluate the efficacy of MDT for healing Atypical and refractory DFUs.Materials & Methods: Patients with atypical diabetic foot ulcers were selected and further evaluated for some predefined differential diagnoses like atypical fungal, parasitic or bacterial infections, malignancy, trauma, etc. After discussion of different available treatment methods, those patients who selected MDT entered the study. Results: Forty two DFU patients (26 men, 16 women) with 42 non-healing atypical ulcers were participated in this study from Feb.2014 to Feb.2016. Successful outcome were achieved in 35 patients (83.3%) by MDT and they proceeded to complete debridement and then healing in less than 1.8±0.8 months. Four ulcers persisted, and three more ones (7.1%) led consequently to amputation.Conclusion: MDT may be considered as an effective treatment for atypical DFUs which are unresponsive to conventional therapies.