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Redford K, Murphy K, Hill B. Factors influencing nurses' use of maggot debridement therapy. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S34-S37. [PMID: 39141342 DOI: 10.12968/bjon.2024.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Management of hard-to-heal wounds remains a significant challenge for healthcare systems, with substantial economic burdens. Maggot debridement therapy, using sterile larvae of Lucilia sericata, effectively debrides necrotic tissue and promotes healing, yet its use is limited. This narrative review examines the influences on the use of this form of debridement by registered nurses, focusing on knowledge and attitudes, treatment-related pain, and practical issues. Findings indicate that wound specialist nurses are more knowledgeable and supportive of maggot debridement therapy compared with non-wound specialists, underscoring the need for targeted educational interventions. Pain management is critical, with mixed reports on pain levels, highlighting the necessity for tailored pain-relief strategies. Practical challenges include procurement difficulties and cost, suggesting a need for streamlined processes and clear clinical guidelines. Addressing these barriers through education, research, and improved logistics could enhance the acceptance and use of maggot debridement therapy, improving patient outcomes in wound management.
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Affiliation(s)
- Katie Redford
- Registered Nurse, Vascular Surgery, Freeman Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Kevin Murphy
- Assistant Professor of Nursing, Northumbria University
| | - Barry Hill
- Professor of Acute and Critical Care Nursing/Head of School of Nursing and Midwifery, Buckinghamshire New University, High Wycombe
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2
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Belote A, Hawkinson D, Shoemaker DM. Myiasis as a Vector for Bacteremia: A Unique Case of Helcococcus kunzii and Ignatzschineria ureiclastica/larvae Polymicrobial Bacteremia from Myiasis. Vector Borne Zoonotic Dis 2024. [PMID: 39007166 DOI: 10.1089/vbz.2024.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Detection of Helcococcus kunzii and Ignatzschineria ureiclastica/larvae has been made possible by recent advancements in microbiologic diagnostics. We report the first described case of polymicrobial bacteremia secondary to these two unique pathogens, and only the third case of I. ureiclastica/larvae bacteremia described in the United States. Myiasis has historically been thought of as an infestation. This case adds to the growing body of evidence that myiasis is potentially a vector for bacteria, and bacteremia, and the potential for the spread of other vector-borne diseases.
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Affiliation(s)
- Alex Belote
- Division of Infectious Diseases, Department of Medicine, University of Kansas, Kanas City, Kansas, USA
| | - Dana Hawkinson
- Division of Infectious Diseases, Department of Medicine, University of Kansas, Kanas City, Kansas, USA
| | - D Matthew Shoemaker
- Division of Infectious Diseases, Department of Medicine, University of Kansas, Kanas City, Kansas, USA
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Mayer DO, Tettelbach WH, Ciprandi G, Downie F, Hampton J, Hodgson H, Lazaro-Martinez JL, Probst A, Schultz G, Stürmer EK, Parnham A, Frescos N, Stang D, Holloway S, Percival SL. Best practice for wound debridement. J Wound Care 2024; 33:S1-S32. [PMID: 38829182 DOI: 10.12968/jowc.2024.33.sup6b.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Affiliation(s)
- Dieter O Mayer
- General and Vascular Surgeon, Institute for Advanced Wound Care and Education, Hausen am Albis, Switzerland
| | - William H Tettelbach
- Chief Medical Officer, RestorixHealth, Metairie, LA; Adjunct Assistant Professor, Duke University School of Medicine, Durham, NC, US
| | - Guido Ciprandi
- Plastic and Paediatric Surgeon, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy
| | - Fiona Downie
- Senior Lecturer Advanced Practice, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, UK
| | - Jane Hampton
- Consultant Nurse, Aarhus Kommune, Middle Jutland, Denmark
| | - Heather Hodgson
- Lead Nurse, Tissue Viability, Acute and Partnerships, NHS Greater Glasgow and Clyde, UK
| | | | - Astrid Probst
- ANP Woundmanagement, Kreiskliniken Reutlingen gGmbH, Germany
| | - Greg Schultz
- Professor of Obstetrics and Gynecology, Director, Institute for Wound Research, University of Florida, US
| | - Ewa Klara Stürmer
- Surgical Head of the Comprehensive Wound Centre UKE, Head of Translational Wound Research, Department of Vascular Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - Alison Parnham
- Teaching Associate, Clinical Nurse specialist, Tissue Viability, University of Nottingham, UK
| | | | - Duncan Stang
- Podiatrist and Diabetes Foot Coordinator for Scotland, UK
| | - Samantha Holloway
- Reader and Programme Director, Masters in Wound Healing and Tissue Repair, Centre for Medical Education, School of Medicine, Cardiff University, UK
| | - Steve L Percival
- CEO and Director, Biofilm Centre, 5D Health Protection Group and Professor (Hon), Faculty of Biology, Medicine and Health, University of Manchester, UK
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4
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Sangha MS, Deroide F, Meys R. Wound healing, scarring and management. Clin Exp Dermatol 2024; 49:325-336. [PMID: 38001053 DOI: 10.1093/ced/llad410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/03/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Understanding wound healing is imperative for the dermatological physician to optimize surgical outcomes. Poor healing may result in negative functional, cosmetic and psychological sequelae. This review briefly outlines the physiology of wound healing, with a view to improving the management of wounds and scars, and minimizing the long-term scarring complications.
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Affiliation(s)
| | - Florence Deroide
- Department of Dermatology, Royal Free London NHS Foundation Trust, London, UK
| | - Rhonda Meys
- Department of Dermatology, Royal Free London NHS Foundation Trust, London, UK
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Ning P, Liu Y, Kang J, Cao H, Zhang J. Comparison of healing effectiveness of different debridement approaches for diabetic foot ulcers: a network meta-analysis of randomized controlled trials. Front Public Health 2023; 11:1271706. [PMID: 38146472 PMCID: PMC10749485 DOI: 10.3389/fpubh.2023.1271706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/21/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives The choice of the debridement method is very important for the healing of diabetic foot ulcers (DFUs), but the relative effectiveness of different debridement methods in the healing of DFUs remains unclear. This study conducted a network meta-analysis of the relative healing effectiveness of different debridement methods in patients with DFUs. Methods We performed a literature search in PubMed, Embase, and Cochrane Library from database inception up to 30 June 2023 for screening randomized controlled trials on the healing effectiveness of debridement in DFUs. Outcome measures included ulcer healing rate and ulcer area reduction rate. The Cochrane Risk Bias Tool, version 2.0, was used to assess the risk of bias in the included trials. R software was used for performing statistical analysis and GraphPad Prism was used for image plotting. Results A total of 19 randomized controlled trials were included, and 900 patients with DFUs were assessed in this analysis. The proteolytic fraction from the latex of Vasconcellea cundinamarcensis (P1G10) in enzymatic debridement showed the best ulcer healing rate (SURCA = 0.919) when compared with the standard of care (SOC) group, with a mean difference (MD) and 95% confidence interval (CI) of 1.40 (0.57, 2.36). Kiwifruit extract demonstrated the best effect on the ulcer area reduction rate (SURCA = 0.931), when compared with that in the SOC group, with an MD and 95% CI of 0.47 (0.27, 0.66). Conclusion Enzymatic debridement was superior to other debridement methods in terms of ulcer healing rate and ulcer area reduction rate in patients with DFUs. However, as the quality of the included trials is low, enzymatic debridement can be used as a candidate debridement method in addition to sharp-based debridement in clinical practice. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441715.
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Affiliation(s)
| | | | | | - Hongyi Cao
- Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Jiaxing Zhang
- Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
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Gulumbe BH, Abdulrahim A. Pushing the frontiers in the fight against antimicrobial resistance: the potential of fecal and maggot therapies. Future Sci OA 2023; 9:FSO899. [PMID: 37753364 PMCID: PMC10518815 DOI: 10.2144/fsoa-2023-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
The escalating crisis of antimicrobial resistance (AMR) warrants innovative therapeutic strategies. Fecal microbiota transplantation (FMT) and maggot debridement therapy (MDT) represent paradigm-shifting approaches, leveraging biological systems to mitigate AMR. FMT restores a healthy gut microbiome, providing a biotherapeutic counter to pathogenic bacteria, thereby reducing reliance on traditional antibiotics. Conversely, MDT, a form of bio-debridement, utilizes the antimicrobial secretions of maggots to cleanse wounds and eliminate resistant bacteria. Despite the promise these therapies hold, their broader clinical adoption faces multifaceted challenges including the need for rigorous scientific substantiation, standardized protocols, deepened understanding of mechanisms of action, and surmounting regulatory and public acceptance barriers. However, their potential integration with precision medicine could revolutionize disease management, particularly with antibiotic-resistant infections.
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Affiliation(s)
- Bashar Haruna Gulumbe
- Department of Microbiology, Faculty of Science, Federal University, Kalgo, Birnin Kebbi, PMB, 1157, Nigeria
| | - Abdulrakib Abdulrahim
- Department of Microbiology, Faculty of Science, Federal University, Kalgo, Birnin Kebbi, PMB, 1157, Nigeria
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Kaviani E, Hajibabaie F, Abedpoor N, Safavi K, Ahmadi Z, Karimy A. System biology analysis to develop diagnostic biomarkers, monitoring pathological indexes, and novel therapeutic approaches for immune targeting based on maggot bioactive compounds and polyphenolic cocktails in mice with gastric cancer. ENVIRONMENTAL RESEARCH 2023; 238:117168. [PMID: 37742751 DOI: 10.1016/j.envres.2023.117168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/26/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
Early diagnosis and prognosis are prerequisites for mitigating mortality in gastric cancer (GaCa). Identifying some causative or sensitive elements (coding RNA (cRNA)-non-cRNAs (ncRNAs)) can be very helpful in the early diagnosis of GaCa. Notably, despite significant development in the GaCa treatment, the outcome of patients does not remain satisfactory due to limitations such as multi-drug resistance and tumor relapse. Therefore, more attention has been drawn to complementary therapies and the use of supplements. In this regard, Polyphenol natural compounds (PNC) and maggot larvae (MaLa) alone or in combination were administered along with chemotherapy (paclitaxel) to N-methyl-N-nitrosourea (MNU)- induced murine tumor model. In addition, in order to identify potential diagnostic or prognostic biomarkers, transcriptomics analysis was performed through a bioinformatics approach. Then transcription profile of ncRNAs with their target hub genes was assessed through qPCR Real-Time, Western blot, and ELISA. According to the bioinformatics results, 17 hub genes (e.g., IL-6, CXCL8, MKI67, IL-2, IL-4, IL-10, IL-1β, SPP1, LOX, COL1A1, and IFN-γ) were explored that contribute towards inflammation and oxidative stress and ultimately GaCa development. Upstream of the mentioned hub genes, regulatory factors (lncRNA XIST and NEAT1) were also identified and introduced as prognosis and diagnosis biomarkers for GaCa. Our results showed that PNC alone and in combination with MaLa was able to reduce the size and number of tumors, which is related to the reduction of genes expression levels (including IL-6, CXCL8, MKI67, IL-2, IL-4, IL-10, IL-1β, SPP1, LOX, COL1A1, IFN-γ, NEAT1, and XIST). In conclusion, PNC and MaLa have the potential to be considered as complementary and improving chemotherapy due to their effective compounds. Also, the introduced hub gene and lncRNA in addition to diagnostic and prognostic biomarkers can be used as druggable proteins for novel therapeutic targeting of GaCa.
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Affiliation(s)
- Elina Kaviani
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fatemeh Hajibabaie
- Department of Physiology, Medicinal Plants Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran; Department of Biology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
| | - Navid Abedpoor
- Department of Physiology, Medicinal Plants Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran; Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Kamran Safavi
- Department of Plant Biotechnology, Medicinal Plants Research Centre, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Zahra Ahmadi
- Department of Physiology, Medicinal Plants Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran; Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
| | - Azadeh Karimy
- Department of Plant Biotechnology, Medicinal Plants Research Centre, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
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Bazaliński D, Przybek-Mita J, Pytlak K, Kardyś D, Bazaliński A, Kucharzewski M, Więch P. Larval Wound Therapy: Possibilities and Potential Limitations-A Literature Review. J Clin Med 2023; 12:6862. [PMID: 37959326 PMCID: PMC10647679 DOI: 10.3390/jcm12216862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Patient-centered care (PCC) is recognized as a standard in healthcare for determining high quality. Honoring patients' values, experiences, needs, and preferences in devising, coordinating, and delivering care underscores the enhancement of the therapeutic rapport between patients and healthcare providers. Wound treatment involves a multi-stage process encompassing diagnostics and local wound dressing, which reduces the risk of infection through a coordinated interdisciplinary team. Within this team, nurses undertake specific professional functions and roles. The implementation of local therapy using innovative and scientifically substantiated methods may be hindered by a deficit of knowledge or inappropriate knowledge among staff and patients themselves. This study presents the challenges concerning the care of patients with chronic wounds treated using Lucilia sericata larvae, based on a review of the current scientific literature. A critical analysis of the literature spanning from 2002 to 2022 was conducted using the Medline, PubMed, Cochrane, and Termedia databases, employing keywords such as "maggot debridement therapy" in relation to acceptance and perception. As a result of the preliminary selection, 472 papers were identified, of which 12 publications were included in the development of this concept. The acquired data were organized and presented in the concluding section in the form of tables, accompanied by descriptions and references to individual studies. Negative psychological and somatic sensations were among the most prominent challenges among patients treated with Maggot Debridement Therapy (MDT). Pain related to peripheral ischemia or infection in this group of patients requires pain prophylaxis, including hyperalgesia and allodynia, in order to improve method tolerance. On the other hand, augmenting patients' understanding of MDT diminishes negative emotions, reinforces positive behaviors, and mitigates anxiety levels. MDT constitutes an effective and safe method. Its widespread use for chronic wounds requires substantial knowledge among healthcare professionals and patient education, along with that of their caregivers, to develop a positive attitude.
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Affiliation(s)
- Dariusz Bazaliński
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland; (D.B.); (K.P.)
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Joanna Przybek-Mita
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland;
- Postgraduate Nursing and Midwifery Education Centre, 35-083 Rzeszów, Poland
| | - Kamila Pytlak
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland; (D.B.); (K.P.)
| | - Daria Kardyś
- Frederic Chopin Provincial Clinical Hospital No. 1, 35-055 Rzeszów, Poland;
| | - Adrian Bazaliński
- Student Scientific Association of Nurses, Sanok State University, 38-500 Sanok, Poland;
| | - Marek Kucharzewski
- Collegium Medicum, Jan Długosz Częstochowa University, 42-200 Częstochowa, Poland;
| | - Paweł Więch
- Institute of Health Protection, State University of Applied Sciences in Przemyśl, 37-700 Przemyśl, Poland
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Bozorgmehr R, Rezaei MM, Jafarabadi K, Alibeik N, Rahimian N, Ahmadinejad M. A rare case of carotid artery injury during maggot debridement therapy for locally advanced parotid gland carcinoma. Int J Surg Case Rep 2023; 111:108844. [PMID: 37722309 PMCID: PMC10518678 DOI: 10.1016/j.ijscr.2023.108844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/20/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Maggot debridement therapy (MDT) is a treatment for chronic ulcers that involves using live larvae to debride the wound. CASE PRESENTATION We report a case of serious arterial bleeding in the cervical region in a 52-year-old woman who was hospitalized in Iran for a malignant ulcer of the retro-auricular area. The patient was brought to the hospital by Emergency medical service due to severe hemorrhagic shock. CLINICAL DISCUSSION Debridement is a commonly used method for wound management, aimed at reducing the risk of infection and removing ulcer debridement. Several techniques are available for debridement of chronic wounds, including mechanical, surgical, autolytic, and enzymatic methods, each with its own advantages and disadvantages. CONCLUSION Maggot debridement therapy (MDT) is one of these methods that seem to be relatively safer. In this method, some larvae are used for debriding wounds in patients. It is usually used as a last resort treatment but in this case, it was used as a third line after surgery and chemoradiotherapy.
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Affiliation(s)
- Ramin Bozorgmehr
- Department of General Surgery, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Moein Rezaei
- Department of General Surgery, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Kyana Jafarabadi
- Department of General Surgery, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nazanin Alibeik
- Department of Internal Medicine, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Rahimian
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mojtaba Ahmadinejad
- Department of General Surgery, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
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Gaffari J, Akbarzadeh K, Baniardalani M, Hosseini R, Masoumi S, Amiri ZS, Shabani Kordshouli R, Rafinejad J, Dahmardehei M. Larval therapy vs conventional silver dressings for full-thickness burns: a randomized controlled trial. BMC Med 2023; 21:361. [PMID: 37726738 PMCID: PMC10510148 DOI: 10.1186/s12916-023-03063-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND This is the first clinical trial to investigate the effectiveness of maggot debridement therapy (MDT) for full-thickness burn injuries in comparison to conventional silver dressings. METHODS Thirty-one cases with full-thickness (grade III based on ICD-10 classifications version 2019) burns were assigned into larval therapy (15 cases) and conventional treatment (16 cases) groups. Participants in the MDT group have received loose larvae on days 0, 2, 4, and 6, while controls received a conventional regimen comprised of sharp debridement, silver sulfadiazine, antibiotic therapy, and offloading every day. The primary and secondary outcomes were defined as the time to debridement (from admission to skin autograft) and time to healing (from admission to complete healing post-skin autograft). Patients in two groups were also compared in terms of necrosis resolution, granulation, and granulation/necrosis (g/n) ratio during study time periods. RESULTS Participants who received larvae had significantly decreased necrosis on days 2 (p = 0.028) and 4 (p = 0.023) compared to those who received control treatment. Significant differences (p < 0.001) were also observed for granulation between the two groups in favor of MDT and the fold changes of g/n in the larvae group were 5, 15, and 13 times higher than that for the conventional regimen on days 2, 4, and 6 of treatment, respectively. Strikingly, a subgroup analysis of high necrotic burns (necrosis > 50%) revealed a significant improvement (p < 0.001) for MDT compared to the control treatment. There were also significant differences (p < 0.001) for the time to debridement and time to healing between the two groups. However, bacterial contamination did not show significant changes between the two treatment regimens. CONCLUSIONS Our findings revealed that MDT has a favorable superiority over conventional regimen for the treatment of grade-III burns, and thus further clinical trials with larger sample size are warranted to confirm these results.
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Affiliation(s)
- Jasem Gaffari
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Akbarzadeh
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Baniardalani
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Hosseini
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safdar Masoumi
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Zahra Sadat Amiri
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Shabani Kordshouli
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Rafinejad
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Chin JD, Zhao L, Mayberry TG, Cowan BC, Wakefield MR, Fang Y. Photodynamic Therapy, Probiotics, Acetic Acid, and Essential Oil in the Treatment of Chronic Wounds Infected with Pseudomonas aeruginosa. Pharmaceutics 2023; 15:1721. [PMID: 37376169 PMCID: PMC10301549 DOI: 10.3390/pharmaceutics15061721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
As a prevalent medical problem that burdens millions of patients across the world, chronic wounds pose a challenge to the healthcare system. These wounds, often existing as a comorbidity, are vulnerable to infections. Consequently, infections hinder the healing process and complicate clinical management and treatment. While antibiotic drugs remain a popular treatment for infected chronic wounds, the recent rise of antibiotic-resistant strains has hastened the need for alternative treatments. Future impacts of chronic wounds are likely to increase with aging populations and growing obesity rates. With the need for more effective novel treatments, promising research into various wound therapies has seen an increased demand. This review summarizes photodynamic therapy, probiotics, acetic acid, and essential oil studies as developing antibiotic-free treatments for chronic wounds infected with Pseudomonas aeruginosa. Clinicians may find this review informative by gaining a better understanding of the state of current research into various antibiotic-free treatments. Furthermore. this review provides clinical significance, as clinicians may seek to implement photodynamic therapy, probiotics, acetic acid, or essential oils into their own practice.
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Affiliation(s)
- Jaeson D. Chin
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
| | - Lei Zhao
- The Department of Respiratory Medicine, The Second People’s Hospital of Hefei and Hefei Hospital Affiliated to Anhui Medical University, Hefei 230002, China
| | - Trenton G. Mayberry
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Braydon C. Cowan
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Mark R. Wakefield
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
- Ellis Fischel Cancer Center, University of Missouri, Columbia, MO 65212, USA
| | - Yujiang Fang
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
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Bazaliński D, Przybek-Mita J, Lisowicz K, Skórka M, Więch P. Defensins of Lucilia sericata Larvae and Their Influence on Wound Repair Processes in Practical Assessment-A Study of Three Cases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5357. [PMID: 37047972 PMCID: PMC10094115 DOI: 10.3390/ijerph20075357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
Bacteria inhabiting chronic wounds form a biofilm that prolongs and slows down the healing process. Increasingly common antibiotic resistance requires clinicians to search for effective and alternative treatment methods. Defensins are the most common antimicrobial peptides capable of eradicating pathogens. Their discovery in maggot secretions allowed for a broader understanding of the healing mechanisms, and approving the use of Lucilia sericata fly larvae in the treatment of infected wounds resulted in an effective and safe procedure. The aim of the study was to present the possibility of biofilm elimination in a chronic wound by means of medical maggots (Lucilia sericata) with the example of three selected clinical cases. The observation included three women who met the inclusion criterion of having venous insufficiency ulcers with inhibited regeneration processes. Medical maggots were applied in a biobag for three days, and observation was conducted for 21 consecutive days. In 2 cases, a significant elimination of necrotic tissue from the wound bed with local granulation tissue was observed 72 h after application of a larvae colony on the wounds. In 1 case, the application of the larvae accelerated the repair process by reducing the wound area by approximately 40% at the time of observation. The formation of biofilm in a chronic wound is one of the main causes of disturbances in its effective healing. Combining procedures (scraping, antiseptic compresses, MDT, NPWT) related to wound debridement increases the effectiveness of biofilm elimination. The use of medical maggots is a safe and effective method of choice, and it enhances the processes of debridement. However, confirmed indisputable data on their effectiveness and frequency of use in the process of stimulating healing processes are still not available in the literature.
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Affiliation(s)
- Dariusz Bazaliński
- Father B. Markiewicz Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland
- Department of Nursing and Public Health, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Joanna Przybek-Mita
- Department of Medical Rescue, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Postgraduate Nursing and Midwifery Education Centre, 35-083 Rzeszów, Poland
| | - Katarzyna Lisowicz
- Department of Nursing, Institute of Health and Economy, Carpathian State University in Krosno, 38-400 Krosno, Poland
| | - Mateusz Skórka
- St Hedvig Clinical Provincial Hospital No. 2 in Rzeszów, 35-301 Rzeszów, Poland
| | - Paweł Więch
- Department of Nursing and Public Health, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Department of Nursing, Institute of Health Protection, State University of Applied Sciences in Przemyśl, 37-700 Przemyśl, Poland
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Raja JM, Maturana MA, Kayali S, Khouzam A, Efeovbokhan N. Diabetic foot ulcer: A comprehensive review of pathophysiology and management modalities. World J Clin Cases 2023; 11:1684-1693. [PMID: 36970004 PMCID: PMC10037283 DOI: 10.12998/wjcc.v11.i8.1684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/08/2023] [Accepted: 02/17/2023] [Indexed: 03/07/2023] Open
Abstract
Diabetic foot ulcer (DFU) is a debilitating and severe manifestation of uncontrolled and prolonged diabetes that presents as ulceration, usually located on the plantar aspect of the foot. Approximately 15% of individuals with diabetes will eventually develop DFU, and 14%-24% of them will require amputation of the ulcerated foot due to bone infection or other ulcer-related complications. The pathologic mechanisms underlying DFU are comprise a triad: Neuropathy, vascular insufficiency, and secondary infection due to trauma of the foot. Standard local and invasive care along with novel approaches like stem cell therapy pave the way to reduce morbidity, decrease amputations, and prevent mortality from DFU. In this manuscript, we review the current literature with focus on the pathophysiology, preventive options, and definitive management of DFU.
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Affiliation(s)
- Joel M Raja
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN 38119, United States
| | - Miguel A Maturana
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN 38119, United States
| | - Sharif Kayali
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN 38119, United States
| | - Amir Khouzam
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN 38119, United States
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Shamloul G, Khachemoune A. Reappraisal and updated review of maggot debridement therapy in chronic lower extremity ulcers. Int J Dermatol 2023. [PMID: 36880424 DOI: 10.1111/ijd.16619] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/29/2022] [Accepted: 02/07/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Dating back to the mid-1500s, maggot debridement therapy (MDT) has been a viable treatment modality for chronic wounds. In early 2004, the sterile larvae of Lucilia sericata received FDA approval for medical marketing for neuropathic, venous, and pressure ulcers, traumatic or surgical wounds, and nonhealing wounds that have not responded to standard care. However, it currently remains an under-utilized therapy. The proven efficacy of MDT begs the question if this treatment modality should be considered as a first-line option for all or a subset of chronic lower extremity ulcers. OBJECTIVE This article aims to address the history, production, and evidence of MDT and discuss future considerations for maggot therapy in the healthcare field. METHODS A literature search using the PubMed database was conducted using keywords, such as wound debridement, maggot therapy, diabetic ulcers, venous ulcers, among others. RESULTS MDT reduced short-term morbidity in non-ambulatory patients with neuroischemic diabetic ulcers and comorbidity with peripheral vascular disease. Larval therapy was associated with statistically significant bioburden reductions against both Staphylococcus aureus and Pseudomonas aeruginosa. Faster time to debridement was achieved when chronic venous or mixed venous and arterial ulcers were treated with maggot therapy versus hydrogels. CONCLUSIONS The literature supports the use of MDT in decreasing the significant costs of treating chronic lower extremity ulcers, with emphasis on those of diabetic origin. Additional studies with global standards for reporting outcomes are necessary to substantiate our results.
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Affiliation(s)
- Gelan Shamloul
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Amor Khachemoune
- Veterans Affairs Hospital and SUNY Downstate Dermatology Service, Brooklyn, NY, USA
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Beyond the Risk of Biofilms: An Up-and-Coming Battleground of Bacterial Life and Potential Antibiofilm Agents. Life (Basel) 2023; 13:life13020503. [PMID: 36836860 PMCID: PMC9959329 DOI: 10.3390/life13020503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
Microbial pathogens and their virulence factors like biofilms are one of the major factors which influence the disease process and its outcomes. Biofilms are a complex microbial network that is produced by bacteria on any devices and/or biotic surfaces to escape harsh environmental conditions and antimicrobial effects. Due to the natural protective nature of biofilms and the associated multidrug resistance issues, researchers evaluated several natural anti-biofilm agents, including bacteriophages and their derivatives, honey, plant extracts, and surfactants for better destruction of biofilm and planktonic cells. This review discusses some of these natural agents that are being put into practice to prevent biofilm formation. In addition, we highlight bacterial biofilm formation and the mechanism of resistance to antibiotics.
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16
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Identification, molecular characterization, and in silico structural analysis of larval salivary glands Netrin-A as a potent biomarker from Lucilia sericata (Diptera: Calliphoridae). Genetica 2022; 150:379-394. [PMID: 36136258 DOI: 10.1007/s10709-022-00164-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 07/29/2022] [Indexed: 11/04/2022]
Abstract
The greenbottle blowfly Lucilia sericata (L. sericata) is increasingly used in larval therapy of chronic wounds. Netrins as bifunctional proteins are in the superfamily of Laminins secreted from larval salivary glands. The Netrin protein has a significant instructive role in axon guidance, causing neuronal outgrowth, angiogenesis, and cell migration. It seems to be crucial in wound healing and acts as a potential biomarker in diagnosing some clinical diseases. This survey aimed to identify molecular features and analyze in silico structural configuration of Netrin-A in L. sericata larvae. The larvae were reared under standard maggotarium conditions. The nucleic acid sequence of L. sericata Netrin-A (LSN-A) was then identified using rapid amplification of circular DNA ends (RACE) and rapid amplification of genomic ends (RAGE). Parts of the Netrin-A gene, including the middle, 3'-, and 5'-ends, were identified, TA cloned in pTG19 plasmid, and transferred into DH5ɑ Escherichia coli. Each part was sequenced and assembled using SeqMan software. This gene structure was further subjected to in silico analysis. The DNA of LSN-A was identified to be 2407 bp, while its mRNA sequence was recognized as 2115 bp by Oligo0.7 software. It translated the Netrin-A protein with 704 amino acid residues. Its estimated molecular weight was 78.6 kDa. Sequencing of this fragment and its BLAST analysis revealed laminin-based high (95%) similarity with the mRNA sequence of Lucilia cuprina Netrin-A. The 3-D structure of Netrin-A drawn by SWISS-MODEL exhibited its partial resemblance to the reference molecule Netrin-1 of Homo sapiens. This study supports the molecular and structural analyses of LSN-A protein, which could lead to wound treatment. Ultimately, it can be an effective candidate to ameliorate injury. Our next attempt is to produce LSN-A recombinant protein for use in biomedical sciences.
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Novel Sources of Bioactive Molecules: Gut Microbiome of Species Routinely Exposed to Microorganisms. Vet Sci 2022; 9:vetsci9080380. [PMID: 35893773 PMCID: PMC9331562 DOI: 10.3390/vetsci9080380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/13/2022] Open
Abstract
Simple Summary The majority of antibiotics available in the market are produced by bacteria isolated from soil. However, the low-hanging fruit has been picked; hence, there is a need to mine bacteria from unusual sources. With this in mind, it is important to note that animals and pests, such as cockroaches, snake, crocodiles, water monitor lizards, etc., come across pathogenic bacteria regularly, yet flourish in contaminated environments. These species must have developed methods to defend themselves against pathogens. Besides the immunity they may confer, bacteria associated with animals/pests may offer a potential source of novel antibacterial agents. This paper discusses the current knowledge of bacteria isolated from land and marine animals with antibacterial properties and proposes untapped sources for the isolation of bacteria to mine potentially novel antibiotic molecules. Abstract The development of novel bioactive molecules is urgently needed, especially with increasing fatalities occurring due to infections by bacteria and escalating numbers of multiple-drug-resistant bacteria. Several lines of evidence show that the gut microbiome of cockroaches, snakes, crocodiles, water monitor lizards, and other species may possess molecules that are bioactive. As these animals are routinely exposed to a variety of microorganisms in their natural environments, it is likely that they have developed methods to counter these microbes, which may be a contributing factor in their persistence on the planet for millions of years. In addition to the immune system, the gut microbiota of a host may thwart colonization of the gastro-intestine by pathogenic and/or foreign microorganisms through two mechanisms: (i) production of molecules with antibacterial potential targeting foreign microorganisms, or (ii) production of molecules that trigger host immunity targeting foreign microorganisms that penetrate the host. Herein, we discuss and deliberate on the current literature examining antibacterial activities that stem from the gut bacteria of animals such as crocodiles, cockroaches, and water monitor lizards, amongst other interesting species, which likely encounter a plethora of microorganisms in their natural environments. The overall aim is to unveil a potential library of novel bioactive molecules for the benefit of human health and for utilization against infectious diseases.
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Phang ZH, Khoo SS, Gunasagaran J, Tunku Ahmad TS. Clinical outcome of Maggot Debridement Therapy followed by Negative Pressure Wound Therapy for chronic hand wound with Multi-Drug Resistant Organism infection: Two cases and review of the literature. J Orthop Surg (Hong Kong) 2022; 29:23094990211067302. [PMID: 34920683 DOI: 10.1177/23094990211067302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The advancement in science and research has led to development of medical maggots which feed exclusively on dead tissue. Medical maggots have three important functions namely debridement, disinfection, and stimulation of wound healing. The modern use of medical maggots now goes by the term "Maggot Debridement Therapy" (MDT) for use in wound management. MDT is still used infrequently due to the effectiveness of surgical debridement and antibiotics for treatment of wound infection. Lately, there was emergence of Multi-Drug Resistant Organism (MDRO) likely due to inappropriate antibiotics usage. Maggot secretions have been shown to be effective in inhibiting some MDRO, for example, Methicillin-resistant Staphylococcus aureus, thus making MDT an attractive option for wounds with MDRO. We report two patients with multiple medical comorbidities, diagnosed with serious MDRO Diabetic Hand Infections treated with three cycles of MDT followed by Negative Pressure Wound Therapy.
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Affiliation(s)
- Zi Hao Phang
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Saw Sian Khoo
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Jayaletchumi Gunasagaran
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
| | - Tunku Sara Tunku Ahmad
- National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, 65300University Malaya, Kuala Lumpur, Malaysia
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19
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Egan G, Phuagkhaopong S, Matthew SAL, Connolly P, Seib FP. Impact of silk hydrogel secondary structure on hydrogel formation, silk leaching and in vitro response. Sci Rep 2022; 12:3729. [PMID: 35260610 PMCID: PMC8904773 DOI: 10.1038/s41598-022-07437-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/15/2022] [Indexed: 11/09/2022] Open
Abstract
Silk can be processed into a broad spectrum of material formats and is explored for a wide range of medical applications, including hydrogels for wound care. The current paradigm is that solution-stable silk fibroin in the hydrogels is responsible for their therapeutic response in wound healing. Here, we generated physically cross-linked silk fibroin hydrogels with tuned secondary structure and examined their ability to influence their biological response by leaching silk fibroin. Significantly more silk fibroin leached from hydrogels with an amorphous silk fibroin structure than with a beta sheet-rich silk fibroin structure, although all hydrogels leached silk fibroin. The leached silk was biologically active, as it induced vitro chemokinesis and faster scratch assay wound healing by activating receptor tyrosine kinases. Overall, these effects are desirable for wound management and show the promise of silk fibroin and hydrogel leaching in the wider healthcare setting.
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Affiliation(s)
- Gemma Egan
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, UK.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK
| | - Suttinee Phuagkhaopong
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK
| | - Saphia A L Matthew
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK
| | - Patricia Connolly
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, UK.
| | - F Philipp Seib
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK. .,EPSRC Future Manufacturing Research Hub for Continuous Manufacturing and Advanced Crystallisation (CMAC), University of Strathclyde, Technology and Innovation Centre, 99 George Street, Glasgow, G1 1RD, UK.
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20
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Choobianzali B, Goli R, Hassanpour A, Ghalandari M, Abbaszadeh R. Reviving hope by using of maggot debridement therapy in patients with diabetic foot ulcer: A case report study. Int J Surg Case Rep 2022; 91:106797. [PMID: 35093705 PMCID: PMC8808047 DOI: 10.1016/j.ijscr.2022.106797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/21/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction and importance Refractory diabetic foot ulcers (DFUs) do not easily respond to standard therapeutic approaches and the prevention of DFU-related amputation is one of the most important aspects of treatment in patients with DFU. Case presentation The present case report is 51-year old male patient with a history of 5-years type 2 diabetes who has had DFU on the first distal phalanx foot of his right foot with size of 2 × 2 cm. The patient was repeatedly hospitalized for receiving DFU treatment, he did not recover using routine wound treatment. The patient was transferred to our wound care team. After ten sessions (one session every 48 h) of maggot debridement therapy (MDT) using sterile Lucilia sericata, the patients' DFU had completely healed. Clinical discussion DFUs can change patient's quality of life and lead to infection, amputation, sepsis, and finally death. Thus, efficient therapeutic methods are necessary for management of DFUs. Conclusion This case report was revealed that the maggot therapy is an affordable and highly efficacious treatment method to enhance the recuperation of DFUs. Therefore, it is recommended that wound care teams use this approach to speed up the healing process. DFU is one of the most significant complications of diabetes mellitus. Affordable and efficacious treatment is necessary for the management of DFUs. Maggot debridement therapy is effective approach for healing DFUs.
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Affiliation(s)
- Babak Choobianzali
- Department of Emergency Medicine, Urmia University of Medical Sciences, Medicine Faculty, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Urmia, Iran.
| | - Amireh Hassanpour
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Urmia, Iran
| | - Mahmoodreza Ghalandari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Urmia, Iran
| | - Rana Abbaszadeh
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad university of Urmia, Nursing and Midwifery Faculty, Urmia, Iran
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Kaczmarek A, Boguś M. The metabolism and role of free fatty acids in key physiological processes in insects of medical, veterinary and forensic importance. PeerJ 2021; 9:e12563. [PMID: 35036124 PMCID: PMC8710053 DOI: 10.7717/peerj.12563] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/07/2021] [Indexed: 12/16/2022] Open
Abstract
Insects are the most widespread group of organisms and more than one million species have been described. These animals have significant ecological functions, for example they are pollinators of many types of plants. However, they also have direct influence on human life in different manners. They have high medical and veterinary significance, stemming from their role as vectors of disease and infection of wounds and necrotic tissue; they are also plant pests, parasitoids and predators whose activities can influence agriculture. In addition, their use in medical treatments, such as maggot therapy of gangrene and wounds, has grown considerably. They also have many uses in forensic science to determine the minimum post-mortem interval and provide valuable information about the movement of the body, cause of the death, drug use, or poisoning. It has also been proposed that they may be used as model organisms to replace mammal systems in research. The present review describes the role of free fatty acids (FFAs) in key physiological processes in insects. By focusing on insects of medical, veterinary significance, we have limited our description of the physiological processes to those most important from the point of view of insect control; the study examines their effects on insect reproduction and resistance to the adverse effects of abiotic (low temperature) and biotic (pathogens) factors.
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Affiliation(s)
- Agata Kaczmarek
- Witold Stefański Institute of Parasitology, Polish Academy of Sciences, Warsaw, Poland
| | - Mieczysława Boguś
- Witold Stefański Institute of Parasitology, Polish Academy of Sciences, Warsaw, Poland
- Biomibo, Warsaw, Poland
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Thomas DC, Tsu CL, Nain RA, Arsat N, Fun SS, Sahid Nik Lah NA. The role of debridement in wound bed preparation in chronic wound: A narrative review. Ann Med Surg (Lond) 2021; 71:102876. [PMID: 34745599 PMCID: PMC8554455 DOI: 10.1016/j.amsu.2021.102876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/07/2023] Open
Abstract
Objective To provide an overview of the types of wound debridement and update the available scientific consensus on the effect of wound debridement. Methods The articles were searched through CINAHL, PubMed, Cochrane Library, and Medline database for relevant articles on all types of wound debridement. Articles included were all systematic review on the effectiveness of wound debridement-related outcome, published within the year 2017 until Aug 2021, in English. Results A total of seven scientific articles had been selected for review out of 318 screened. The authors reviewed a total of 318 titles and abstracts related to wound debridement effectiveness. Seven articles that were selected were narratively reviewed by two authors. The findings of the review were organized into autolytic, enzymatic, sharp, surgical, biological, and mechanical debridement methods and includes the advantages and disadvantages of each. The author further explored on the role of wound debridement according to wound bed preparation model. Articles were synthesized and organized based on the authors, year, total studies included in the systematic review, study range of year, total sample, debridement method, wound types, and findings. Conclusion Maggot debridement therapy showed a consistent finding in terms of effectiveness in debriding chronic wounds. The newer debridement method includes hydro-surgery, low-frequency ultrasonic and enzymatic collagenase debridement were getting more attention due to faster wound bed preparation and less painful. However, these newer method of debridements showed inconclusive findings and the patient safety was not clearly defined. A higher level of review is warranted in the future study. Maggot debridement therapy (MDT) showed a consistent positive effect in treating chronic wounds. New debridement methods that gaining more attention includes hydro-surgery, low-frequency ultrasonic and enzymatic collagenase debridement. Newer debridement method reported faster wound bed preparation and deemed to be less pain. Patient safety was not clearly defined in these newer debridement methods.
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Affiliation(s)
- Deena Clare Thomas
- Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Chong Li Tsu
- Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Rose A Nain
- Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Norkiah Arsat
- Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Soong Shui Fun
- Department of Nursing, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Nik Amin Sahid Nik Lah
- Department of Surgery, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, UMS Road, 88400, Kota Kinabalu, Sabah, Malaysia
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