Sun X, Jiang K, Chen J, Wu L, Lu H, Wang A, Wang J, et al.
International journal of infectious diseases : IJID : official publication of the International.... Date of publication 2014 Aug 1;volume 25():32-7.
1. Int J Infect Dis. 2014 Aug;25:32-7. doi: 10.1016/j.ijid.2014.03.1397. Epub 2014
May 16.
A systematic review of maggot debridement therapy for chronically infected wounds
and ulcers.
Sun X(1), Jiang K(1), Chen J(1), Wu L(2), Lu H(3), Wang A(4), Wang J(5).
Author information:
(1)Department of Endocrinology, The 454(th) Hospital of Chinese PLA, Nanjing,
China.
(2)Department of Epidemiology and Biostatistics, School of Public Health, Nanjing
Medical University, Nanjing, China.
(3)Department of Social Medicine and Health Education, School of Public Health,
Nanjing Medical University, Nanjing, China.
(4)Department of Endocrinology, The 454(th) Hospital of Chinese PLA, Nanjing,
China. Electronic address: wap454hospital@163.com.
(5)Department of Epidemiology and Biostatistics, School of Public Health, Nanjing
Medical University, Nanjing, China; Department of Social Medicine and Health
Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Electronic address: jmwang@njmu.edu.cn.
OBJECTIVE: This study aimed to systematically evaluate maggot debridement therapy
(MDT) in the treatment of chronically infected wounds and ulcers.
METHODS: We performed a meta-analysis referring to the PRISMA statement
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched
for published articles in the following databases: PubMed, Web of Science,
Embase, Wanfang (Chinese), and the China National Knowledge Infrastructure
(CNKI). The latest search was updated on March 14, 2014. For dichotomous
outcomes, the effects of MDT were expressed as the relative risk (RR) and 95%
confidence interval (CI). For continuous outcomes with different measurement
scales, we calculated the standardized mean difference (SMD). The pooled effects
were estimated using a fixed effect model or random effect model based on the
heterogeneity test. Subgroup analyses were performed according to the types of
wounds or ulcers.
RESULTS: MDT had a significantly increased positive effect on wound healing
compared with conventional therapies, with a pooled RR of 1.80 (95% CI
1.24-2.60). The subgroup analysis revealed that the combined RRs were 1.79 (95%
CI 0.95-3.38) for patients with diabetic foot ulcers (DFU) and 1.70 (95% CI
1.28-2.27) for patients with other types of ulcers. The time to healing of the
ulcers was significantly shorter among patients treated with MDT, with a pooled
SMD of -0.95 (95% CI -1.24, -0.65). For patients with DFU, the SMD was -0.79 (95%
CI -1.18, -0.41), and for patients with other types of ulcers, the SMD was -1.16
(95% CI -1.63, -0.69).
CONCLUSION: MDT not only shortened the healing time but also improved the healing
rate of chronic ulcers. Therefore, MDT may be a feasible alternative in the
treatment of chronic ulcers.
Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
DOI: 10.1016/j.ijid.2014.03.1397
PMID: 24841930 [Indexed for MEDLINE]
