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Babiarczyk B, Tobiczyk J. Patient Perceptions and Experiences With Maggot Debridement Therapy for Managing Chronic Wounds. J Wound Ostomy Continence Nurs 2024; 51:180-184. [PMID: 38595216 DOI: 10.1097/won.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE The purpose of this study was to describe patient experiences and satisfaction with use of maggot debridement therapy (MDT) for hard-to-heal wounds. DESIGN Descriptive, cross-sectional study. SUBJECTS AND SETTING The sample comprised 60 participants, 60% were male (n = 36). Their mean age was 62.9 (SD = 20) years. Almost half of participants had lower extremity wounds (n = 26; 43.3%), diabetic foot ulcers (n = 18; 30%), and pressure injuries (n = 9; 15%). Most received maggot therapy via biobags (n = 36; 60%). METHODS Participants completed a questionnaire designed for purposes of the study that queried demographic and pertinent clinical characteristics, current health status including current topical therapies, and duration of their chronic wound. Nine items queried emotional responses prior to MDT, the amount and method of the maggot therapy, discomfort experienced during therapy, and sources of information regarding this treatment. RESULTS Emotional responses before starting MDT included disgust (n = 30, 50%), anxiety (n = 26, 43.3%), doubts about its effectiveness (n =20, 33.3%), and disbelief (n = 11, 18.3%). Approximately one-third of participants reported feelings of biting, itching, and fear of the maggots. Despite these feelings, a majority (n = 38, 63.3%) indicated that they were pleased with treatment outcome and willing to undergo additional MDT if needed. CONCLUSIONS While a majority of participants with nonhealing chronic wounds reported negative emotions association with MDT, more than half indicated that they were pleased with the outcome of treatment and willing to undergo repeat treatment if indicated.
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Affiliation(s)
- Beata Babiarczyk
- Beata Babiarczyk, MN, HSD, RN, Department of Nursing, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
- Joanna Tobiczyk, MN, RN, Department of General Surgery, Silesian Hospital in Cieszyn, Cieszyn, Poland
| | - Joanna Tobiczyk
- Beata Babiarczyk, MN, HSD, RN, Department of Nursing, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
- Joanna Tobiczyk, MN, RN, Department of General Surgery, Silesian Hospital in Cieszyn, Cieszyn, Poland
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Dehghan O, Tabaie SM, Rafinejad J, Toutounchi M, Tiyuri A, Azarmi S, Esmaeeli Djavid G, Akbarzadeh K. A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2). INT J LOW EXTR WOUND 2024; 23:133-139. [PMID: 34533091 DOI: 10.1177/15347346211044295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In the present study, the efficiency of two formulations of maggot therapy: free-range larvae on the wounds and larvae in a special bag (larval-bag), was compared for healing diabetic ulcers with Wagner 2 diabetic ulcer. This study was conducted as a parallel randomized clinical trial. Out of 281 patients with Wagner grade 2 diabetic ulcers referred to the wound clinic, 54 patients who met the inclusion criteria were randomly assigned to intervention groups. The disinfected larvae of Lucilia sericata were put on the wounds with 2 methods, free-range larvae and larval-bag. Follow up was done at every 48 h interval until the full appearance of granulated tissues. The main measures were wound bed preparation, removing of necrotic tissues, appearing of granulated tissues, and removing of bacterial infections in the wounds. Statistical analysis based on the Kaplan-Meier curve and the Wilcoxon (Breslow) test showed a significant reduction in wound healing time by using free-range larvae in comparison with larval-bag (P = .03). The median time to debridement was 4 days in the free-range larval group (95% confidence interval: 3-9 days) while it was 9 days in the larval-bag group (95% confidence interval: 5-16 days). Debridement rate (proportion of removed necrotic tissue surfaces) at any time in the free-ranged larvae group was 1.78 times that of the bagged larvae group (95% confidence interval 1.01-3.15, P = .036). There was no significant difference between free-range larval use and larval-bag in the acceptability of maggot therapy by patients (P = .48). It can be concluded that both of two formulations of the larval therapy (free-range larvae and larval-bag) could be recommended for cleaning out and bed preparation of diabetic ulcers. However, using free-range larvae is hardly recommended on the wounds which are eligible to use.
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Affiliation(s)
- Omid Dehghan
- Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Amir Tiyuri
- Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Azarmi
- Tehran University of Medical Sciences, Tehran, Iran
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Martinez-Rojano H, Huerta H, Sámano R, Chico-Barba G, Mier-Cabrera J, Plascencia-Nieto ES. Ophthalmomyiasis Externa and Importance of Risk Factors, Clinical Manifestations, and Diagnosis: Review of the Medical Literature. Diseases 2023; 11:180. [PMID: 38131986 PMCID: PMC10743177 DOI: 10.3390/diseases11040180] [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: 10/15/2023] [Revised: 12/02/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE This review aims to describe and compare the risk factors, clinical course, diagnosis, and parasitologic features of external ophthalmomyiasis. We also discuss the different preventive measures and the effect of global warming in a large case series reported from January 2000 to December 2022. METHODS We perform a literature review of reported cases of external ophthalmomyiasis to determine the clinical characteristics, therapeutic management, and information on the organisms that most commonly cause external ophthalmomyiasis. RESULTS A total of 312 cases of external ophthalmomyiasis were recorded. The most common causative organism was Oestrus ovis (Linnaeus) (Diptera: Oestridae), accounting for 72.1% of cases, followed by Dermatobia hominis (Linnaeus Jr. in Pallas, 1781) (Diptera: Oestridae) at 5.4%, Lucilia sericata (Meigen) (Diptera: Calliphoridae) at 0.96%, and Chrysomyia bezziana (Villeneuve) (Diptera: Calliphoridae) at 0.96%. Before experiencing symptoms, 43.6% of cases reported having direct contact with flies or being hit in the eye, 33% reported no associated risk factors, 9.3% reported living with sheep and goats, and 7.7% reported a history of foreign objects entering the eye. The most common symptoms for those affected by O. ovis were sudden onset, including a foreign body sensation and movement, redness, tearing, itching, swelling, irritation, photophobia, burning, and ocular secretion. In cases caused by D. hominis, symptoms included eyelid edema, pain, redness, itching, movement within the lesion, ocular irritation, and discharge. Regarding occupational or recreational activity, agriculture, and livestock had the highest incidence, followed by trades and technical activities, being a student, and having traveled to an endemic region for work or recreation. CONCLUSION Patients with red eyes may suffer from external ophthalmomyiasis, which requires a thorough examination to diagnose and treat it early. Moreover, as the temperature increases due to climate change, it is essential to consider how this will affect the spread of different pathogens.
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Affiliation(s)
- Hugo Martinez-Rojano
- Sección de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Colonia Casco de Santo Tomas, Delegación Miguel Hidalgo, Ciudad de México 11340, Mexico;
- Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos, Francisco de P. Miranda No. 177, Colonia Unidad Lomas de Plateros, Ciudad de México 01480, Mexico
| | - Herón Huerta
- Laboratorio de Entomología, Instituto de Diagnóstico y Referencia Epidemiológicos, Francisco de P. Miranda No. 177, Colonia Unidad Lomas de Plateros, Ciudad de México 01480, Mexico;
| | - Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Lomas de Virreyes, Alcaldía Miguel Hidalgo, Ciudad de México 11000, Mexico; (R.S.); (G.C.-B.); (J.M.-C.)
| | - Gabriela Chico-Barba
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Lomas de Virreyes, Alcaldía Miguel Hidalgo, Ciudad de México 11000, Mexico; (R.S.); (G.C.-B.); (J.M.-C.)
| | - Jennifer Mier-Cabrera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Lomas de Virreyes, Alcaldía Miguel Hidalgo, Ciudad de México 11000, Mexico; (R.S.); (G.C.-B.); (J.M.-C.)
| | - Estibeyesbo Said Plascencia-Nieto
- Sección de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Colonia Casco de Santo Tomas, Delegación Miguel Hidalgo, Ciudad de México 11340, Mexico;
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Radzikowska-Büchner E, Łopuszyńska I, Flieger W, Tobiasz M, Maciejewski R, Flieger J. An Overview of Recent Developments in the Management of Burn Injuries. Int J Mol Sci 2023; 24:16357. [PMID: 38003548 PMCID: PMC10671630 DOI: 10.3390/ijms242216357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.
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Affiliation(s)
- Elżbieta Radzikowska-Büchner
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Inga Łopuszyńska
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Wojciech Flieger
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4 Street, 20-090 Lublin, Poland;
| | - Michał Tobiasz
- Department of Plastic Surgery, Reconstructive Surgery and Burn Treatment, Medical University of Lublin, Krasnystawska 52 Street, 21-010 Łęczna, Poland;
| | - Ryszard Maciejewski
- Faculty of Medicine, University of Warsaw, Żwirki i Wigury 101 Street, 02-089 Warszawa, Poland;
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A Street, 20-093 Lublin, Poland
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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: 0] [Impact Index Per Article: 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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González JA, Vallejo JR. The Use of Shells of Marine Molluscs in Spanish Ethnomedicine: A Historical Approach and Present and Future Perspectives. Pharmaceuticals (Basel) 2023; 16:1503. [PMID: 37895974 PMCID: PMC10609972 DOI: 10.3390/ph16101503] [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: 09/04/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Since ancient times, the shells of marine molluscs have been used as a therapeutic and/or prophylactic resource. In Spain, they were part of practical guides for doctors or pharmacists until the 19th century. In general, seashells were prepared by dissolving in vinegar and were part of plasters or powders used as toothpaste, or to treat dyspepsia, heartburn and leprosy. Thus, the nacre or mother-of-pearl of various molluscs was regularly used in the Royal Colleges of Surgery and in hospitals during the times of the Cortes of Cadiz, as a medicine in galenic preparations based on powders. In contemporary Spanish ethnomedicine, seashells, with a high symbolic value, have been used as an amulet to prevent cracks in the breasts and promote their development during lactation, to avoid teething pain in young children, to eliminate stains on the face or to cure erysipelas. But, as in other countries, products derived from seashells have also been empirically applied. The two resources used traditionally have been the cuttlebone, the internal shell of cuttlefish and the nacre obtained from the external shells of some species. Cuttlebone, dried and pulverised, has been applied externally to cure corneal leukoma and in dental hygiene. In the case of nacre, a distinction must be made between chemical and physical remedies. Certain seashells, macerated in lemon juice, were used in coastal areas to remove spots on the face during postpartum. However, the most common practice in Spain mainland was to dissolve mother-of-pearl buttons in lemon juice (or vinegar). The substance thus obtained has been used to treat different dermatological conditions of the face (chloasma, acne), as well as to eliminate freckles. For the extraction of foreign bodies in the eyes, a very widespread traditional remedy has been to introduce small mother-of-pearl buttons under the lid. These popular remedies and practices are compared with those collected in classic works of medicine throughout history, and data on the pharmacological activity and pharmaceutical applications of the products used are provided. The use of cuttlebone powders is supported by different works on anti-inflammatory, immune-modulatory and/or wound healing properties. Nacre powder has been used in traditional medicines to treat palpitations, convulsions or epilepsy. As sedation and a tranquilisation agent, nacre is an interesting source for further drug development. Likewise, nacre is a biomaterial for orthopaedic and other tissue bioengineering applications. This article is a historical, cultural and anthropological view that can open new epistemological paths in marine-derived product research.
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Affiliation(s)
- José A. González
- Grupo de Investigación de Recursos Etnobiológicos del Duero-Douro (GRIRED), Facultad de Biología, Universidad de Salamanca, E-37071 Salamanca, Spain
| | - José Ramón Vallejo
- Departamento de Anatomía Patológica, Biología Celular, Histología, Historia de la Ciencia, Medicina Legal y Forense y Toxicología, Área de Historia de la Ciencia, Facultad de Medicina, Universidad de Cádiz, E-11003 Cádiz, Spain;
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Baghbani MR, Rashidi S, Naderi Shahabadi S, Ebrahimi S, Alipour S, Asgari Q, Motazedian MH. The in vitro and in vivo effects of Lucilia sericata larval secretions on Leishmania major. J Parasit Dis 2023; 47:363-368. [PMID: 37193496 PMCID: PMC10182202 DOI: 10.1007/s12639-023-01574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/26/2023] [Indexed: 04/08/2023] Open
Abstract
The emerging of drug resistant against Leishmania parasites prompts scientists to seek for novel therapeutic strategies against theses infectious protozoan parasites. Among different strategies, the use of larvae secretions could be suggested as a possible therapy with low side effects. Accordingly, the current study evaluated the in vitro and in vivo effects of Lucilia sericata larval secretions on Leishmania major, the causative agent of cutaneous leishmaniasis (CL). After preparation of L. sericata larval stages (L2 and L3) secretions, the potential effects of secretions were evaluated against L. major promastigotes and amastigotes (in vitro) using MTT assay. The cytotoxicity effects of secretions were also checked on uninfected macrophages. In addition, in vivo experiments were also conducted to investigate the effects of larvae's secretions on the CL lesions induced in the BALB/c mice. Although the increased concentration of larvae secretions exhibited a direct effect on the promastigotes proliferation (viability), contrarily, L2 secretions at a concentration of 96 μg/ml represented the highest inhibitory effect on parasite (amastigotes) burden in infected macrophages. Interestingly, L3 secretions > 60 μg/ml induced inhibitory effects on amastigotes. The results relevant to the cytotoxicity effects of L2 and L3 secretions on uninfected-macrophages showed a dose dependent correlation. In vivo results were also significant, compared to the positive control group. This study suggested the plausible inhibitory effects of L. sericata larvae's secretions on the L. major amastigotes and CL lesions progression. It seems that the characterization of all effective components/proteins in the larvae secretions and their specific targets in parasite structure or in cell (macrophage) responses could further reveal more details regarding the anti-leishmanial properties of these compounds.
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Affiliation(s)
- Mohammad Reza Baghbani
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Rashidi
- Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Shahrbanoo Naderi Shahabadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Ebrahimi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeideh Alipour
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Qasem Asgari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Motazedian
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Basic Science in Infectious Diseases, Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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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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Przybek-Mita J, Bazaliński D, Szewczyk MT, Kardyś D, Mańkowski B, Więch P. Nurses' Readiness to Undertake Controlled Negative Pressure Therapy in the Treatment of Chronic Wounds-Research Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3388. [PMID: 36834083 PMCID: PMC9966321 DOI: 10.3390/ijerph20043388] [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: 10/26/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Local wound treatment with negative pressure wound therapy (NPWT) shortens the healing process but requires the supervision of trained medical personnel for administering the therapeutic procedures. Professional supervision and control of the effectiveness of NPWT, as well as education conducted by nurses, are of particular importance for therapeutic and caring processes, both in hospital and at home. The aim of the study was the assessment of the perception of NPWT by certified nurses in the topical treatment of chronic wounds. The study was conducted using the method of estimation and a diagnostic survey with the proprietary NPWT perception questionnaire: 495 subjects were enrolled in the study and 401 respondents aged 25-67 years qualified for statistical analysis. Despite their experience and competence, the respondents critically assessed their knowledge, pointing to an average subjective level of knowledge related to wound treatment and a low level of knowledge related to NPWT. Most of the respondents had no experience of independent treatment using this method. The data obtained from the questionnaire clearly indicate theoretical preparation and high motivation to undertake activities related to the implementation of NPWT in their own practice. Low readiness values suggested that the subjects did not have the resources or the ability to implement the method. The perception of NPWT in the surveyed group of nurses was determined by numerous factors, including self-assessment of their own knowledge, motivation and readiness to use NPWT. A high level of NPWT perception was noted, despite low motivation related to the availability and knowledge of the method. Theoretical knowledge is insufficient to implement innovative methods in local wound treatment. Practical skills and motivation are indispensable elements that should be met during the training and education of nurses in the field of wound care.
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Affiliation(s)
- 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
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów Father B. Markiewicz, 36-200 Brzozów, Poland
| | - Maria Teresa Szewczyk
- Department of Perioperative Nursing, Department of Surgical Nursing and Chronic Wound Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland
| | - Daria Kardyś
- Department of Hematology, Clinical Provincial F. Chopin Memorial Hospital No. 1, 2 Szopen Street, 35-055 Rzeszów, Poland
| | - Bartosz Mańkowski
- General Surgery and Multi-Organ Disorders Ward, Multidisciplinary Municipal J. Struś Memorial Hospital in Poznań, 61-285 Poznań, Poland
- Craniofacial Surgery Clinic of Medical University in Poznań, 61-701 Poznań, Poland
| | - Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland
- Departmenet of Nursing, Institute of Health Protection, State University of Applied Sciences in Przemyśl, 37-700 Przemyśl, Poland
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Srivastava P, Sondak T, Sivashanmugam K, Kim KS. A Review of Immunomodulatory Reprogramming by Probiotics in Combating Chronic and Acute Diabetic Foot Ulcers (DFUs). Pharmaceutics 2022; 14:2436. [PMID: 36365254 PMCID: PMC9699442 DOI: 10.3390/pharmaceutics14112436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 08/29/2023] Open
Abstract
Diabetic foot ulcers (DFUs) are characterized by a lack of angiogenesis and distal limb diabetic neuropathy. This makes it possible for opportunistic pathogens to protect the biofilm-encased micro-communities, causing a delay in wound healing. The acute and chronic phases of DFU-associated infections are distinguished by the differential expression of innate proinflammatory cytokines and tumor necrosis factors (TNF-α and -β). Efforts are being made to reduce the microbial bioburden of wounds by using therapies such as debridement, hyperbaric oxygen therapy, shock wave therapy, and empirical antibiotic treatment. However, the constant evolution of pathogens limits the effectiveness of these therapies. In the wound-healing process, continuous homeostasis and remodeling processes by commensal microbes undoubtedly provide a protective barrier against diverse pathogens. Among commensal microbes, probiotics are beneficial microbes that should be administered orally or topically to regulate gut-skin interaction and to activate inflammation and proinflammatory cytokine production. The goal of this review is to bridge the gap between the role of probiotics in managing the innate immune response and the function of proinflammatory mediators in diabetic wound healing. We also highlight probiotic encapsulation or nanoformulations with prebiotics and extracellular vesicles (EVs) as innovative ways to tackle target DFUs.
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Affiliation(s)
- Prakhar Srivastava
- Department of Chemistry and Chemistry Institute of Functional Materials, Pusan National University, Busan 46241, Korea
| | - Tesalonika Sondak
- Department of Chemistry and Chemistry Institute of Functional Materials, Pusan National University, Busan 46241, Korea
| | - Karthikeyan Sivashanmugam
- School of Biosciences and Technology, High Throughput Screening Lab, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India
| | - Kwang-sun Kim
- Department of Chemistry and Chemistry Institute of Functional Materials, Pusan National University, Busan 46241, Korea
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11
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Song M, Bai X, Wang D, Wang Q, Pan L, He P, Gong Y, Sun X, Xu X, Che J, Wang S. Combined application of moist exposed burn ointment and maggot therapy in wound healing. J Wound Care 2022; 31:S41-S52. [DOI: 10.12968/jowc.2022.31.sup10.s41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Hard-to-heal wounds are a global health challenge, and effective treatments are still lacking. Moist exposed burn ointment (MEBO) and maggots are traditional treatments for promoting wound healing. This study was a preliminary exploration of combined maggot therapy and MEBO in the treatment of hard-to-heal wounds. Method: A coexistence experiment was conducted to determine the survival rates of maggots in MEBO. The maggots were placed in two different existence conditions: one set in MEBO (MEBO group), and another set as the control group (no MEBO) to compare survival rates. Case reports describe the use of the combined application of MEBO and maggots in the treatment of patients with hard-to-heal wounds. Results: The coexistence experiment indicated that maggots in the MEBO group had a higher survival rate. From the therapeutic effect of the clinical cases (n=7), the combined application was safe and effective, with all the reported wounds eventually healing. Conclusion: Based on the findings of this study, we believe the combined application of MEBO and maggots is a promising way of promoting wound healing. Further studies and clinical trials are needed to elucidate the mechanism of the combined application in promoting wound healing and to more persuasively clarify the therapeutic effect.
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Affiliation(s)
- Mingzhi Song
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 2 Department of Orthopaedics, the Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaodong Bai
- 3 Department of Plastic Surgery, Southern University of Science and Technology Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Deyu Wang
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Qingxin Wang
- 5 The Second Department of General Surgery, the Fifth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Liwen Pan
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ping He
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ying Gong
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaohong Sun
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaoguang Xu
- 8 Research Center of High Altitude Medicine, Naqu, Tibet, People's Republic of China
- 9 People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, Tibet, People's Republic of China
| | - Jianzhong Che
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Shouyu Wang
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 10 Dalian Runxi Technology Development Co. Ltd, Dalian, Liaoning, People's Republic of China
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12
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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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13
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Maggot debridement therapy in the tropics – Preliminary outcomes from a tertiary hospital. J Tissue Viability 2022; 31:544-551. [DOI: 10.1016/j.jtv.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/18/2022] [Accepted: 05/20/2022] [Indexed: 11/20/2022]
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14
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Kandregula B, Narisepalli S, Chitkara D, Mittal A. Exploration of Lipid-Based Nanocarriers as Drug Delivery Systems in Diabetic Foot Ulcer. Mol Pharm 2022; 19:1977-1998. [PMID: 35481377 DOI: 10.1021/acs.molpharmaceut.1c00970] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus is a chronic manifestation characterized by high levels of glucose in the blood resulting in several complications including diabetic wounds and ulcers, which predominantly require a longer duration of treatment and adversely affect the quality of life of the patients. Nanotechnology-based therapeutics (both intrinsic and extrinsic types) have emerged as a promising treatment in diabetic foot ulcer/chronic wounds owing to their unique characteristics and specific functional properties. In this review, we have focused on the significance of the use of lipids in the healing of diabetic ulcers, their interaction with the injured skin, and recent trends in lipid-based nanocarriers for the healing of diabetic wounds. Lipid nanocarriers are also being investigated for gene therapy in diabetic wound healing to encapsulate nucleic acids such as siRNA and miRNA, which could silence the expression of inflammatory cytokines overexpressed in chronic wounds. Additionally, these are also being explored for encapsulating proteins, peptides, growth factors, and other biological genetic material as therapeutic agents. Lipid-based nanocarriers encompassing a wide variety of carriers such as liposomes, niosomes, ethosomes, solid lipid nanoparticles, and lipidoid nanoparticles that are explored for the treatment of foot ulcers supplemented with relevant research studies have been discussed in the present review. Lipid-based nanodrug delivery systems have demonstrated promising wound healing potential, particularly in diabetic conditions due to the enhanced efficacy of the entrapped active molecules.
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Affiliation(s)
- Bhaskar Kandregula
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani 333031, Rajasthan, India
| | - Saibhargav Narisepalli
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani 333031, Rajasthan, India
| | - Deepak Chitkara
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani 333031, Rajasthan, India
| | - Anupama Mittal
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani 333031, Rajasthan, India.,Department of Cellular and Molecular Biology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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15
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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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16
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Bazaliński D, Przybek Mita J, Ścisło L, Więch P. Perception and Readiness to Undertake Maggot Debridement Therapy with the Use of Lucilia sericata Larvae in the Group of Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052895. [PMID: 35270587 PMCID: PMC8910558 DOI: 10.3390/ijerph19052895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
The sight and smell of larvae in the wound may cause negative visual and olfactory impressions in sensitive individuals because of decaying body parts, carrion, and suffering. However, Maggot Debridement Therapy (MDT) is highly effective, safe, and cheap in wound healing and tissue revitalization for both the patient and health systems. The aim of the study was to assess the readiness to undertake MDT in a group of qualified nurses who perform therapeutic procedures in patients treated for chronic wounds. A diagnostic survey was used. The research tool was a scientific research protocol consisting of three questionnaires (sociodemographics, MDT perception questionnaire, pictures of wounds for visual assessment). The study included 290 nurses; the mean age was over 42.6 ± 9.9 years, and the median was 44 years. The perception and readiness to implement the method in the tested sample is at the average (standard) level. The image of maggots in the wound causes negative emotions among medical personnel. The higher the knowledge of the MDT method, the greater the motivation to implement it in practice.
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Affiliation(s)
- Dariusz Bazaliński
- Father B. Markiewicz Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland;
- 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
| | - Lucyna Ścisło
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Nursing and Midwifery, Medical College, Jagiellonian University, 31-501 Krakow, Poland;
| | - Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Rzeszów, Poland;
- Institute of Social Sciences and Health Protection, East European State Higher School in Przemyśl, 37-700 Przemyśl, Poland
- Correspondence: ; Tel.: +48-667-192-696
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17
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Lucillia Sericata larval therapy in the treatment of diabetic chronic wounds. J Diabetes Metab Disord 2022; 21:305-312. [PMID: 35673427 PMCID: PMC9167379 DOI: 10.1007/s40200-022-00973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/03/2022] [Indexed: 01/29/2023]
Abstract
Purpose Wounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment. Methods The sterile larvae were used in wound treatment and the infection rate, Erythrocyte Sedimentation Rate (ESR), and wound size were measured and compared before and after the treatment. Results The scars of 40 patients in the larval therapy group were evaluated every 10 days and the mean size of the scar decreased from 38.5 cm (36.6 cm) before treatment to 5.0 cm (6.6 cm) after 60 days. ESR mean was decreased from 57.3 (18.3) before treatment to 15.8 (4.8) after treatment in the larval therapy group. These parameters were significantly decreased compared to the debridement group (p < 0.001). Conclusions Larval therapy is effective in diabetic wound healing. The size of the wound after larval treatment is smaller than before. There was no difference between the two groups for infection rate. ESR was significantly decreased in the larval therapy group that indicating the lower inflammation in this group. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-00973-w.
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18
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Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031338. [PMID: 35162360 PMCID: PMC8834952 DOI: 10.3390/ijerph19031338] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
According to the World Health Organization (WHO), it is estimated that each year approximately 11 million people suffer from burn wounds, 180,000 of whom die because of such injuries. Regardless of the factors causing burns, these are complicated wounds that are difficult to heal and are associated with high mortality rates. Medical care of a burn patient requires a lot of commitment, experience, and multidirectional management, including surgical activities and widely understood pharmacological approaches. This paper aims to comprehensively review the current literature concerning burn wounds, including classification of burns, complications, medical care, and pharmacological treatment. We also overviewed the dressings (with an emphasis on the newest innovations in this field) that are currently used in medical practice to heal wounds.
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19
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Aleksandrowicz H, Owczarczyk-Saczonek A, Placek W. Venous Leg Ulcers: Advanced Therapies and New Technologies. Biomedicines 2021; 9:1569. [PMID: 34829797 PMCID: PMC8615583 DOI: 10.3390/biomedicines9111569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/23/2021] [Indexed: 12/19/2022] Open
Abstract
The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.
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Affiliation(s)
- Hubert Aleksandrowicz
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury, Al. Wojska Polskiego 30, 10-959 Olsztyn, Poland; (A.O.-S.); (W.P.)
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20
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Taleb M. Effectiveness of broad-spectrum antiseptics in production of disinfected maggots of Lucilia sericata for use in wound debridement therapy. Wound Repair Regen 2021; 29:1017-1023. [PMID: 34633134 DOI: 10.1111/wrr.12968] [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: 04/15/2021] [Revised: 08/14/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
The establishment of low-cost, effective, safe and practical methods is necessary to increase the use of larval therapy in wound care. Although studies on external disinfection of calliphorid eggs have been reported, many studies lack data on the effect of disinfection on egg viability and the microorganisms found before disinfection. Therefore, the main objective of this study was to compare three antiseptic solutions, that is, chlorhexidine (5%), Dakin's solution (0.5% NaOCl) and povidone-iodine (10%), in terms of their ability to disinfect Lucilia sericata eggs. Egg viability after disinfection and microorganisms present on the eggs and larvae before and after treatment were also examined. None of the antiseptics had a significant effect on egg viability. Disinfection of L. sericata eggs with 0.5% NaOCl was the best method, as sterility tests showed no contamination. Escherichia coli, Bacillus subtilis and Proteus mirabilis were present in all cultures isolated from the non-disinfected eggs and larvae, while Enterococcus faecium, Enterococcus faecalis, Morganella morganii, Corynebacterium spp. and Providencia stuartii were isolated from more than half of the same cultures. Sterility testing of medicinal maggots after disinfection is crucial to prevent secondary infections and achieve a positive therapeutic outcome.
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Affiliation(s)
- Meriem Taleb
- Department of Biology, Faculty of Nature and Life Sciences, University of Blida 1, Blida, Algeria
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21
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Davis RJ, Belikoff EJ, Dickey AN, Scholl EH, Benoit JB, Scott MJ. Genome and transcriptome sequencing of the green bottle fly, Lucilia sericata, reveals underlying factors of sheep flystrike and maggot debridement therapy. Genomics 2021; 113:3978-3988. [PMID: 34619342 DOI: 10.1016/j.ygeno.2021.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/03/2021] [Accepted: 10/01/2021] [Indexed: 12/13/2022]
Abstract
The common green bottle blow fly Lucilia sericata (family, Calliphoridae) is widely used for maggot debridement therapy, which involves the application of sterile maggots to wounds. The larval excretions and secretions are important for consuming necrotic tissue and inhibiting bacterial growth in wounds of patients. Lucilia sericata is also of importance as a pest of sheep and in forensic studies to estimate a postmortem interval. Here we report the assembly of a 565.3 Mb genome from long read PacBio DNA sequencing of genomic DNA. The genome contains 14,704 predicted protein coding genes and 1709 non-coding genes. Targeted annotation and transcriptional analyses identified genes that are highly expressed in the larval salivary glands (secretions) and Malpighian tubules (excretions) under normal growth conditions and following heat stress. The genomic resources will underpin future genetic studies and in development of engineered strains for genetic control of L. sericata and for biotechnology-enhanced maggot therapy.
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Affiliation(s)
- Rebecca J Davis
- Department of Entomology and Plant Pathology, North Carolina State University, Campus Box 7613, Raleigh, NC 27695-7613, USA.
| | - Esther J Belikoff
- Department of Entomology and Plant Pathology, North Carolina State University, Campus Box 7613, Raleigh, NC 27695-7613, USA.
| | - Allison N Dickey
- Bioinformatics Research Center, North Carolina State University, Campus Box 7566, Raleigh, NC 27695-7566, USA.
| | - Elizabeth H Scholl
- Bioinformatics Research Center, North Carolina State University, Campus Box 7566, Raleigh, NC 27695-7566, USA.
| | - Joshua B Benoit
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH 45211, USA.
| | - Maxwell J Scott
- Department of Entomology and Plant Pathology, North Carolina State University, Campus Box 7613, Raleigh, NC 27695-7613, USA.
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Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe. Microorganisms 2021; 9:microorganisms9091934. [PMID: 34576832 PMCID: PMC8465362 DOI: 10.3390/microorganisms9091934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022] Open
Abstract
Wohlfahrtiimonas chitiniclastica are bacteria that cause rare infections, typically associated with the infestation of an open wound with fly larvae. Here, we present a unique case report of the first W. chitiniclastica isolation from a burn wound with accidental myiasis in a 63-year-old homeless man and a literature review focused on human infections caused by these bacteria. So far, 23 cases of infection with W. chitiniclastica have been reported; in 52% of these, larvae were found in the wound area. Most of these cases suffered from chronic non-healing wound infections but none of these were burn injuries. The overall fatality rate associated directly with W. chitiniclastica in these cases was 17%. Infections with parasitic larvae occur in moderate climates (especially in people living in poor conditions); therefore, an infection with rare bacteria associated with accidental myiasis, such as W. chitiniclastica, can be expected to become more common there. Thus, in view of the absence of recommendations regarding the treatment of patients with accidental myiasis and, therefore, the risk of infection with W. chitiniclastica or other rare pathogens, we provide a list of recommendations for the treatment of such patients. The importance of meticulous microbial surveillance using molecular biological methods to facilitate the detection of rare pathogens is emphasized.
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23
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Lempert M, Pape H, Jukema GN. Salvage of a mangled limb with Matriderm ® augmented split-skin grafting and maggot biodebridement. Clin Case Rep 2021; 9:e04676. [PMID: 34603723 PMCID: PMC8465938 DOI: 10.1002/ccr3.4676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022] Open
Abstract
Salvage of a mangled limb can be a long and strenuous way, but it is feasible even with rather simple techniques such as augmented split-skin grafting and maggot biodebridement.
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Cuestas D, Pedraza J, Herrera H, Motta A, Cuestas A, Forero Y, Porras R, Urrea F, Galvis D, Galvis I, Bernal MA, Alvarado MV, Bula R, Velasquez O, Villalba D, Lamus S, Ariza G, Bayona N, Gutierrez A, Segura A, Patiño M, Perafan A, Ramirez-Rodriguez S, Rolon M. Cutaneous myiasis in skin cancer and malignant wounds: a systematic review. Int J Dermatol 2021; 60:1529-1546. [PMID: 34363696 DOI: 10.1111/ijd.15672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/14/2021] [Accepted: 04/22/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cutaneous myiasis in patients with malignant wounds or skin cancer is a rare and undesirable event with limited epidemiological data. A subregister of reports, lack of education in the population, inadequate empirical treatments, and medical underestimation are components of a public health problem that threatens patients' lives. METHODS We conducted a systematic review of the literature of cutaneous myiasis associated with malignant wounds and skin cancer, characterizing sociodemographic variables, risk factors, clinical and histological features, and treatment. Additionally, we present a demonstrative case with the adequate taxonomic evaluation. DISCUSSION Cutaneous myiasis is an underestimated and poorly managed infestation, which can generate severe complications in oncological patients. This is the first systematic review in the literature about this clinical scenario, which provides information to the physician and clinical researcher about the epidemiological gaps and what has been published so far. CONCLUSIONS Findings from the current review have helped to display the sociodemographic, epidemiological, and clinical behavior of myiasis in skin cancer and malignant wounds. Its contribution to the greater tumor tissue destruction is clear; however, more studies are required. The therapeutic management in these patients is equally clarified.
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Affiliation(s)
- Daniel Cuestas
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,ESTUDIODERMA®, Bogotá, Colombia
| | - John Pedraza
- Dermatology Program, Fundacion Universitaria Sanitas, Bogotá, Colombia
| | - Hugo Herrera
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Adriana Motta
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Andrés Cuestas
- ESTUDIODERMA®, Bogotá, Colombia.,Clinical and Enginnering Research-Statistical Analysis, Predicto Artificial Intelligence Techonologies LLC, Austin, TX, USA
| | - Yency Forero
- Internal Medicine Program, Universidad de La Sabana, Chía, Colombia
| | - Ricardo Porras
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Fernando Urrea
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Dany Galvis
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Ingrid Galvis
- Special Training in Radiology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Rosa Bula
- Clinical Research, Universidad del Sinú, Cartagena, Colombia
| | - Oscar Velasquez
- Dermatology Program, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Sergio Lamus
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Gabriel Ariza
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Natalia Bayona
- Clinical Research, Universidad del Rosario, Bogotá, Colombia
| | - Ana Gutierrez
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Alexandra Segura
- Grupo de Investigación en Ciencias Biomédicas UPTC - GICBUPTC, Grupo de Investigación en Medicina Veterinaria y Zootecnia GIDIMEVETZ, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
| | - Monica Patiño
- Clinical Research, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Alejandra Perafan
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | | | - Mariam Rolon
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,Dermatopathology Department, Hospital Simon Bolívar, Bogotá, Colombia
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25
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Maeda T, Yamamoto Y, Murao N, Hayashi T, Kimura C, Matsui S, Saito T, Matsui H, Osawa M, Funayama E. Maggot debridement therapy in critical limb ischaemia: a case study. J Wound Care 2021; 29:S28-S32. [PMID: 33320762 DOI: 10.12968/jowc.2020.29.sup12.s28] [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: 11/11/2022]
Abstract
OBJECTIVE In critical limb ischaemia (CLI), first-line therapy is revascularisation, but alternative treatment options are needed in certain cases. Maggot debridement therapy (MDT) is historically considered to be contraindicated in ischaemic ulcers. Wound care in patients with CLI is becoming increasingly diverse with the development of novel revascularisation strategies; therefore, CLI now needs to be reconsidered as an indication for MDT. METHOD We retrospectively reviewed five legs with CLI (five male, one female) treated with MDT between January 2013 and December 2017. Changes in skin perfusion pressure (SPP) around the ulcer before and after MDT were evaluated. One or two cycles of MDT were performed (eight in total). We also evaluated the proportion of necrotic tissue in the ulcer and the presence of exposed necrotic bone. The proportion of necrotic tissue in the ulcer was classified as NT 1+ (<25%), NT 2+ (25-50%), NT 3+ (50-75%) or NT 4+ (>75%). RESULTS When the proportion of necrotic tissue was >50%, with no exposed necrotic bone in the wound, an increase in SPP was observed after five (62.5%) of eight cycles of MDT. And with a proportion of necrotic tissue of <25% and/or exposed necrotic bone in the wound, a decrease in SPP was observed after three (37.5%) of eight cycles. Wound healing was accelerated in the presence of increased SPP. CONCLUSION Effective MDT with increased SPP requires an ulcerative state of necrotic tissue grade > NT 3+, with no exposed necrotic bone.
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Affiliation(s)
- Taku Maeda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yuhei Yamamoto
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Naoki Murao
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshihiko Hayashi
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Chu Kimura
- Department of Plastic and Reconstructive Surgery, Hakodate General Central Hospital, Hokkaido, Japan
| | - Suguru Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Tatsuya Saito
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Hotaka Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Masayuki Osawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Emi Funayama
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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26
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Ashour DS, Othman AA. Parasite-bacteria interrelationship. Parasitol Res 2020; 119:3145-3164. [PMID: 32748037 DOI: 10.1007/s00436-020-06804-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
Parasites and bacteria have co-evolved with humankind, and they interact all the time in a myriad of ways. For example, some bacterial infections result from parasite-dwelling bacteria as in the case of Salmonella infection during schistosomiasis. Other bacteria synergize with parasites in the evolution of human disease as in the case of the interplay between Wolbachia endosymbiont bacteria and filarial nematodes as well as the interaction between Gram-negative bacteria and Schistosoma haematobium in the pathogenesis of urinary bladder cancer. Moreover, secondary bacterial infections may complicate several parasitic diseases such as visceral leishmaniasis and malaria, due to immunosuppression of the host during parasitic infections. Also, bacteria may colonize the parasitic lesions; for example, hydatid cysts and skin lesions of ectoparasites. Remarkably, some parasitic helminths and arthropods exhibit antibacterial activity usually by the release of specific antimicrobial products. Lastly, some parasite-bacteria interactions are induced as when using probiotic bacteria to modulate the outcome of a variety of parasitic infections. In sum, parasite-bacteria interactions involve intricate processes that never cease to intrigue the researchers. However, understanding and exploiting these interactions could have prophylactic and curative potential for infections by both types of pathogens.
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Affiliation(s)
- Dalia S Ashour
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, 31527, Egypt.
| | - Ahmad A Othman
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, 31527, Egypt
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27
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Wang TY, Wang W, Li FF, Chen YC, Jiang D, Chen YD, Yang H, Liu L, Lu M, Sun JS, Gu DM, Wang J, Wang AP. Maggot excretions/secretions promote diabetic wound angiogenesis via miR18a/19a - TSP-1 axis. Diabetes Res Clin Pract 2020; 165:108140. [PMID: 32277954 DOI: 10.1016/j.diabres.2020.108140] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/29/2020] [Accepted: 03/30/2020] [Indexed: 12/15/2022]
Abstract
AIMS The impaired angiogenesis is one of the main factors affecting the healing of diabetic foot ulcer (DFU) wounds. Maggot debridement therapy (MDT) promotes granulation tissue growth and angiogenesis during DFU wound healing. Non-coding microRNAs can also promote local angiogenesis in DFU wounds by regulating wound repairing related gene expression. The purpose of this study was to investigate the mechanism of microRNAs in MDT promoting DFU wound angiogenesis. METHODS In this study, we applied MDT to treat DFU wound tissue and detect the expression of the miR-17-92 cluster. In vitro experiments, human umbilical vein endothelial cells (HUVECs) were treated with maggot excretions/secretions (ES), the miR-17-92 cluster and the predicted target gene expression were measured. Tube formation assay and cell scratch assay were performed when inhibition of miR-18a/19a or overexpression of thrombospondin-1 (TSP-1) were used in this study. RESULTS miR-18a/19a transcription significantly up-regulated and TSP-1 expression down-regulated in patients wound tissue and in HUVECs. Inhibition of miR-18a/19a or overexpression of TSP-1 partially blocked the migration and tube formation ability stimulated by ES. CONCLUSION Targeted activation of miR-18a/19a transcription levels and subsequent regulation of TSP-1 expression may be a novel therapeutic strategy for DFU.
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Affiliation(s)
- Tian-Yuan Wang
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Wei Wang
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Fei-Fei Li
- Endocrinology Department, The Second Hospital of Anhui Medical University, No.678 Furong Road, Hefei 230601, China.
| | - Yin-Chen Chen
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Dong Jiang
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Yue-Dong Chen
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Hui Yang
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Lan Liu
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Meng Lu
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Jin-Shan Sun
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Dong-Mei Gu
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Jing Wang
- Translational medicine center, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
| | - Ai-Ping Wang
- Endocrinology Department, Air Force Hospital of Eastern Theater Command, No.1 Malu Road, Nanjing 210002, China.
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28
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Maleki-Ravasan N, Ahmadi N, Soroushzadeh Z, Raz AA, Zakeri S, Dinparast Djadid N. New Insights Into Culturable and Unculturable Bacteria Across the Life History of Medicinal Maggots Lucilia sericata (Meigen) (Diptera: Calliphoridae). Front Microbiol 2020; 11:505. [PMID: 32322242 PMCID: PMC7156559 DOI: 10.3389/fmicb.2020.00505] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 03/09/2020] [Indexed: 12/31/2022] Open
Abstract
Because of the nutritional ecology of dung- and carrion-feeding, bacteria are the integral part of Lucilia sericata life cycle. Nevertheless, the disinfected larvae of the blowfly are applied to treat human chronic wounds in a biosurgery named maggot debridement therapy (MDT). To realize the effects of location/diet on the gut bacteria, to infer the role of bacteria in the blowfly ecology plus in the MDT process, and to disclose bacteria circulating horizontally in and vertically between generations, bacterial communities associated with L. sericata specimens from various sources were investigated using culture-based and culture-independent methods. In total, 265 bacteria, including 20 families, 28 genera, and 40 species, were identified in many sources of the L. sericata. Culture-dependent method identified a number of 144 bacterial isolates, including 21 species, in flies reared in an insectary; specimens were collected from the field, and third-instar larvae retrieved from chronic wounds of patients. Metagenetic approach exposed the occurrences of 121 operational taxonomic units comprising of 32 bacterial species from immature and adult stages of L. sericata. Gammaproteobacteria was distinguished as the dominant class of bacteria by both methods. Bacteria came into the life cycle of L. sericata over the foods and transovarially infected eggs. Enterococcus faecalis, Myroides phaeus, Proteus species, Providencia vermicola, and Serratia marcescens were exchanged among individuals via transstadial transmission. Factors, including diets, feeding status, identification tool, gut compartment, and life stage, governed the bacteria species. Herein, we reemphasized that L. sericata is thoroughly connected to the bacteria both in numerous gut compartments and in different life stages. Among all, transstadially transmitted bacteria are underlined, indicating the lack of antagonistic effect of the larval excretions/secretions on these resident bacteria. While the culture-dependent method generated useful data on the viable aerobic gut bacteria, metagenomic method enabled us to identify bacteria directly from the tissues without any need for cultivation and to facilitate the identification of anaerobic and unculturable bacteria. These findings are planned to pave the way for further research to determine the role of each bacterial species/strain in the insect ecology, as well as in antimicrobial, antibiofilm, anti-inflammatory, and wound healing activities.
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Affiliation(s)
- Naseh Maleki-Ravasan
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran
| | - Nahid Ahmadi
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Department of Biotechnology, Faculty of Advanced Sciences and Technology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Soroushzadeh
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Department of Biotechnology, Faculty of Advanced Sciences and Technology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Ali Raz
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Sedigheh Zakeri
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Navid Dinparast Djadid
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
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