RESUMEN
Foot myiasis is a rare condition, with only a few reported cases and no treatment consensus. We proposeda conservative and unique treatment approach with VAC dressing method. The patient administered in the hospital with presentation of deep tissue injury from a sharp stone, from 3 months back which was maggot infested. The patient had approached local physicians before been admitted in our facility. The wound was severe with maggot infestation. The patient was non diabetic with no other comorbid conditions. We had the aim of infection free wound with faster rate of healing, which was fulfilled by the noveltreatment protocol using vacuum-assisted closure (VAC®) dressing method. Culture sensitivity tests ruled out infection and maggot infestation. The wound was closed surgically after healthy uninfected granulation tissue confirmed with culture sensitivity report. No recurrence of maggot or any other infection were found. The protocol performed was safe and effective in critical case of myiasis.
RESUMEN
Background: Diabetic foot is the commonest complication of Diabetes Mellitus. It is not totally curable or preventable but with positive approach mortality and morbidity due to diabetic foot can be reduced. Aim and objectives: To find out which type of treatment modality is better in terms of costeffectiveness and number of dressings in patients of diabetic foot, to salvage the limb in diabetic patient with help of various modalities of treatment available to our hospitals, to prevent the recurrence of such lesion by careful follow up, by educating the patient about foot care and prescribing pressure distributing footwear, and rehabilitation of patient once the ulcer has healed. Materials and methods: A total of 60 patients having diabetic foot were included. Clinical assessment was done of all patients after admitting them. History and clinical findings were written as per preformed proforma. All patients were sent to foot wear specialist. All this patients initially underwent debridement or removal of necrotic patch, according to the presenting feature. Depending on the condition of the ulcer (size or slough) they were dressed with newer techniques. Newer techniques used were Vac (Vacuum assisted closure) and Non-Vac (Hydrocolloid, Hydrogel, collagen, Platelet derived growth factor). Results: Majority of diabetic patients were having neuropathic and traumatic type of lesions. 30 patients were dressed with V ac (Vacuum assisted closure) and remaining 30 patients were dressed with Non-V ac. In which 5 patients were dressed with Hydrocolloid, 3 patients were dressed with Hydrogel, 12 patients were dressed with collagen and 10 patients were dressed with platelet derived growth factor. Comparison between V ac and Non-V ac types of dressing in terms of number of dressings, duration of stay, cost effectiveness is done by applying Z-Test. It was significant. Desai A, Panchal A, Parmar H. Comparative study in newer techniques for management of diabetic foot. IAIM, 2016; 3(8): 79-82. Page 80 Conclusion: Newer techniques for dressing- VAC or NON-VAC decreases the morbidity of the patient and also better in terms of cost-effectiveness and duration of stay as compared to conventional dressings.
RESUMEN
Decubitus ulcer is a pressure-induced ischemia-reperfusion injury overlying a bony prominence. Various dressing methods have been developed to treat it, but clinical management is still a challenging practice. A patient presented with stage IV decubitus ulcer on the left lateral side of the buttock, which was caused by compulsively lying down on the left side due to schizophrenia. The ulcer was resistant to occlusive dressing method for five weeks. However, the patient successfully recovered in three weeks by our applying a negative pressure dressing with the portable vacuum-assisted closure (VAC) system. Our experience shows negative pressure dressing can be effectively used to treat intractable decubitus ulcer in outpatient settings.