Limb salvage using maggot debridement therapy on a diabetic foot ulcer complicated by gas gangrene: First case report in Nigeria

Abstract

Maggot debridement therapy (MDT) has resurfaced three decades ago as a result of the steep rise in the emergence of antibiotic resistant strains of pathogenic bacteria and the need for an effective non-surgical method for wound debridement in the critically ill patients. This case study reports on the successful use of MDT to salvage the limb of the index patient who was booked for above knee amputation. The patient is a 53-year-old lady who presented with left foot ulcer of six weeks' duration to our facility. Sterile first instar larvae of L. sericata obtained from an indigenous company (Biosurg wound care Nigeria Limited) were applied using the confinement (free-ranged) method. Staphylococcus epidermidis and Pseudomonas fluorescens were isolated before the application of MDT. However, after the application, the wounds m/c/s yielded no growth. Rapid epithelization and increased vascularity of the tissues were observed in the patient after the application. Maggot debridement therapy was successfully used in the debridement of diabetic foot ulcer complicated by gas gangrene in Nigeria for the first time and the clinical outcome is encouraging.