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Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
The wound must be of a type that can benefit from the application of maggot therapy. A moist, exudating wound with sufficient oxygen supply is a prerequisite. Not all wound-types are suitable: wounds which are dry, or open wounds of body cavities do not provide a good environment for maggots to feed.
Patients should avoid exposing their feet to hot water or harsh chemicals, as well should avoid walking barefoot to prevent development of diabetic foot infections. [3] Patients should also be educated about the importance of regularly trimming their toenails and ensuring they are kept short to avoid an infection from developing.
[1] [2] [3] The use of this technique in wound management started in the 1990s and this technique is often recommended for treatment of a range of wounds including dehisced surgical wounds, closed surgical wounds, open abdominal wounds, open fractures, pressure injuries or pressure ulcers, diabetic foot ulcers, venous insufficiency ulcers, some ...
The type of wound (incision, laceration, puncture, etc.) has a major effect on the way a wound is managed, as does the area of the body affected and presence of any foreign objects in the wound. A serious wound or any complication may require a call to emergency medical services. Any wound requires being disinfected after it stops bleeding.
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
Typically, wounds that do not heal within three months are classified as chronic. [1] Chronic wounds may remain in the inflammatory phase due to factors like infection or bacterial burden, ischaemia, presence of necrotic tissue, improper moisture balance of wound site, or underlying diseases such as diabetes mellitus. [2] [3] [4]
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