Patient Perceptions and Experiences With Maggot Debridement Therapy for Managing Chronic Wounds.

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.

[Triple therapy. Bad luck... or don't we still know how to treat?]. / Terapia trójlekowa - pech... czy w dalszym ciagu nie potrafimy stosowac?

A case of a 65 year old male with acute myocardial infarction treated with primary angioplasty and stent implantation is presented. Following infarction, the patient suffered twice from the in-stent thrombosis in spite of triple antiplatelet/anticoagulant therapy. The problem of recurrent restenosis in spite of optimal therapy is discussed.