Uso da terapia larval no tratamento de úlceras crônicas em pacientes diabéticos no Hospital Universitário Onofre Lopes- Natal, RN

Abstract

Larval therapy is the use of sterile larvae in the debridement of wounds. Currently this technique has been widely used in Europe, the U.S.A., and Israel, among other countries, however, has not been implemented in Brazil yet, and there are no reports of its application using larvae of the fly Chrysomya megacephala in human patients. This study aimed to evaluate the debridement of ulcers difficult to heal by using larvae of C. megacephala. Five patients with chronic ulcers were included in the study after answering a questionnaire, to be informed about the possible risks and benefits of larval therapy and signed a Free, Prior and Informed Consent. Before the applications, samples were collected for identification of the bacteria in the ulcers. After this step, the ulcers were evaluated before and during treatment by photographic recording, measurement and evaluation of diameters, percentage of necrotic tissue and granulation. The evaluation was followed by the application of approximately 5 second instar sterile larvae of C. megacephala per cm2 of lesion. Dressings with larvae were exchanged after 48 hours with 48 hours between applications. The patients’ ulcers included in this study had polymicrobial nature and in all of them was isolated Pseudomonas aeruginosa species. All patients underwent larval therapy showed a reduction in the percentage of necrosis, increase of granulation tissue on the surface of ulcers and a consequent improvement during treatment.