Newsgroup: it.scienza.medicina
Titolo: cure di piaghe con larve di mosche -discovery channel-

Ho un problema che spero qualcuno possa aiutarmi a risolvere:
Mercoledi 7 novembre su discovery channel alle 1e40 e' andato in onda un
servizio sulle cure di piaghe con larve di mosche.
Purtroppo ho perso questo questo servizio che mi e' stato indicato da
conoscenti come la soluzione di un grave problema di decubito di mio figlio.
Spero che qualcuno abbia notizie su quel servizio o su questo metodo
curativo.
Grazie

 Mercoledi 7 novembre su discovery channel alle 1e40
discovery .. non mi pare .
ho visto qualcosa in effetti .
Parlavano e facevano vedere qualcosa di una signora che era intollerante (
diceva ) agli anestetici .. mi pare .
Ma il tutto si svolgeva in... america ( ? ) ed era per la psoriasi .
Francamente non ho seguito attentamente ma non mi e' sembrata una grossa
idea .
Quale è esattamente il problema ?
tuo figlio non puo' fare una terapia convenzionale ?
( se trovo qualcosa  cerchero' di postarlo )
--
<== sgas ==> ®
sg...@vene.dave.it
 
sg...@libero.it
  # 69225877

 un servizio sulle cure di piaghe con larve di mosche.
Ecco un abstract del 1995 e altri otto più recenti (1999-2001) per i medici
interessati all'argomento:
  [1] J Spinal Cord Med 1995 Apr;18(2):71-4
 Maggot therapy for treating pressure ulcers in spinal cord injury patients.
 Sherman RA, Wyle F, Vulpe M.
 Medical Service, VA Medical Center, Long Beach, CA 90822, USA.
  For centuries, maggot therapy (MT) has been recognized as an aid to wound
 healing. By including live blowfly larvae in wound dressings, earlier
 physicians noted thorough debridement which hastened wound healing. We
 initiated a prospective controlled study to evaluate the utility of maggot
 therapy for treating pressure ulcers in spinal cord injury patients in the
 modern era. Eight of our patients received MT after a baseline assessment
 of healing under conventional therapy (defined as any therapy prescribed by
 the patient's primary care team). Surface area, tissue quality and healing
 rates were monitored weekly. MT debrided most of the necrotic wounds within
 one week, which was more rapid than all other non-surgical methods. Wound
 healing was more rapid during MT than during antecedent conventional therapy
 (p = 0.01). No complications were seen. We have demonstrated that MT can
 be beneficial in the treatment of pressure ulcers in persons with spinal
 cord injuries. MT was significantly more effective and efficient than the
 current, conventional treatment alternatives being used. MT was also safe,
 simple and inexpensive. MT can be a valuable modality in the treatment of
 pressure ulcers.
 PMID: 7640976
  [2] Int J Dermatol 1999 Aug;38(8):623-7
 Maggot therapy for the treatment of intractable wounds.
 Mumcuoglu KY, Ingber A, Gilead L, Stessman J, Friedmann R, Schulman H,
 Bichucher H, Ioffe-Uspensky I, Miller J, Galun R, Raz I.
 Department of Parasitology, Hebrew University-Hadassah Medical School,
 Jerusalem, Israel.
  BACKGROUND: Fly maggots have been known for centuries to help debride and
 heal wounds. Maggot therapy was first introduced in the USA in 1931 and was
 routinely used there until the mid-1940s in over 300 hospitals. With the
 advent of antimicrobiols, maggot therapy became rare until the early 1990s,
 when it was re-introduced in the USA, UK, and Israel. The objective of this
 study was to assess the efficacy of maggot therapy for the treatment of
 intractable, chronic wounds and ulcers in long-term hospitalized patients
 in Israel. METHODS: Twenty-five patients, suffering mostly from chronic
 leg ulcers and pressure sores in the lower sacral area, were treated in
 an open study using maggots of the green bottle fly, Phaenicia sericata.
 The wounds had been present for 1-90 months before maggot therapy was
 applied. Thirty-five wounds were located on the foot or calf of the
 patients, one on the thumb, while the pressure sores were on the lower back.
 Sterile maggots (50-1000) were administered to the wound two to five times
 weekly and replaced every 1-2 days. Hospitalized patients were treated
 in five departments of the Hadassah Hospital, two geriatric hospitals,
 and one outpatient clinic in Jerusalem. The underlying diseases or the
 causes of the development of wounds were venous stasis (12), paraplegia (5),
 hemiplegia (2), Birger's disease (1), lymphostasis (1), thalassemia (1),
 polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were
 examined daily or every second day until complete debridement of the wound
 was noted. RESULTS: Complete debridement was achieved in 38 wounds (88.4%);
 in three wounds (7%), the debridement was significant, in one (2.3%)
 partial, and one wound (2.3%) remained unchanged. In five patients who
 were referred for amputation of the leg, the extremities was salvaged
 after maggot therapy. CONCLUSIONS: Maggot therapy is a relatively rapid
 and effective treatment, particularly in large necrotic wounds requiring
 debridement and resistant to conventional treatment and conservative
 surgical intervention.
 PMID: 10487456
  [3] Chirurg 1999 Nov;70(11):1340-6
 [Biosurgery - maggots, are they really the better surgeons?]
 [Article in German]
 Fleischmann W, Russ M, Moch D, Marquardt C.
 Unfall- und Wiederherstellungschirurgie, Krankenhaus Bietigheim.
  Between 1 October 1996 and 31 December 1998 123 patients (74 men, 43 women)
 suffering from acute (n = 17) and chronic (n = 21) infections and chronic
 wounds (n = 85) were treated with sterile maggots (Lucilia sericata).
 In most patients the indication for the use of maggots was a failure to
 respond to standard therapy. Healing occurred in all patients with acute
 infections, and chronic infections showed excellent short-term results.
 In chronic wounds disturbances of healing in diabetics responded best
 to maggot therapy, the etiologically inhomogeneous group of leg ulcers
 asked for a polypragmatic approach, and the worst results were seen
 in chronic arterial occlusive disease (stage 4). Our limited experience
 with "biosurgery", biased selection of patients, and lack of late results
 reduce the significance of our data; nevertheless, sterile maggots seem
 to be an astonishingly workable tool for solving problems in surgical
 wound treatment.
 PMID: 10591775
  [4] J R Soc Med 2000 Feb;93(2):72-4
 Larva therapy in wound management.
 Courtenay M, Church JC, Ryan TJ.
 Churchill Hospital, Department of Dermatology, Headington, Oxford, UK.
  The use of maggots for wound debridement has a long history and has lately
 gained ground in several countries. We collected prospective data to examine
 the current use of larva therapy (LT) in the UK. Quantitative information
 was collected on 70 patients treated in nine hospitals. LT is used primarily
 to treat leg ulcers and generally involves three applications of larvae
 at two to three day intervals. This method is judged effective in wound
 debridement and promotes the growth of granulation tissue. Wound exudate,
 odour, infection and pain are all reduced by the treatment. Adverse
 reactions are infrequent but include pain, bleeding, pyrexia and
 influenza-like symptoms. Prevention of hospital admission and surgery,
 reduced need for antibiotics and reduced hospital stay are all identified
 as outcomes of LT. The nurse practitioners who used LT believed it to
 have an important role in wound management. A randomized clinical trial,
 comparing LT with other debriding agents, is required for evaluation of
 cost effectiveness.
 PMID: 10740573
  [5] J Burn Care Rehabil 2000 May-Jun;21(3):254-7
 Biodebridement: a case report of maggot therapy for limb salvage
 after fourth-degree burns.
 Namias N, Varela JE, Varas RP, Quintana O, Ward CG.
 Jackson Memorial Hospital Burn Center, Daughtry Family Department
 of Surgery, University of Miami School of Medicine, Fla. 33101, USA.
  The wound healing and antimicrobial properties of maggots are well known.
 Maggot debridement therapy has been used for the treatment of various
 conditions. For maggot debridement therapy, the larvae of the blowfly
 are applied over necrotic or nonhealing wounds. We used maggot debridement
 therapy with the larvae of Phaenicia sericata for limb salvage after
 bilateral lower extremity fourth-degree burns.
 PMID: 10850908
  [6] J Eur Acad Dermatol Venereol 2000 Jul;14(4):285-9
 Biosurgery in wound healing--the renaissance of maggot therapy.
 Wollina U, Karte K, Herold C, Looks A.
 Department of Dermatology, Friedrich-Schiller-University of Jena, Germany.
 
uw...@derma.uni-jena.de
  Chronic wounds are a challenge for modern health care. A basic principle
 of treatment is the removal of sloughy, necrotic, devitalized tissue to
 prevent wound infection and delayed healing. Biosurgery (syn. maggot or
 larval therapy) is a promising adjunct to the whole spectrum of topical
 treatment methods, in particular for debridement. The term 'biosurgery'
 describes the use of living maggots on wounds to remove devitalized tissue,
 decrease the risk of infection and improve wound healing. The present paper
 gives a brief review of history, entomology, biochemistry and medical
 indications of biosurgery and the practical handling of maggots. We also
 provide some clinical data from the literature and our own experience in a
 wound care unit. Biosurgery is an effective and safe treatment option for
 debridement and disinfection.
 PMID: 11204517
  [7] J Tissue Viability 2000 Jul;10(3):91-4
 The cost effectiveness of larval therapy in venous ulcers.
 Wayman J, Nirojogi V, Walker A, Sowinski A, Walker MA.
 West Cumberland Hospital, Whitehaven, Cumbria, UK.
  The treatment of necrotic ulcers involves considerable nursing time and
 expense. The current standard treatment involves repeated application of
 hydrogels. Larval debridement therapy (LDT) has been shown anecdotally to
 clear ulcers of necrotic slough but has never been compared directly with
 'modern' therapies. The aim of this study has been to compare LDT with
 hydrogel dressings in the treatment of necrotic venous ulcers. 12 patients
 with sloughy venous ulcers were randomised to receive either LDT or the
 control therapy--a hydrogel. Effective debridement occurred with a maximum
 of one larval application in 6/6 patients. 2/6 in the hydrogel group still
 required dressings at one month. The median cost of treatment of the larval
 group was 78.64 Pounds compared with 136.23 Pounds for the control treatment
 group (p < 0.05). The study confirms both the clinical efficacy and cost
 effectiveness of larval therapy in the debridement of sloughy venous ulcers.
 PMID: 11299572
  [8] MMW Fortschr Med 2001 Apr 19;143(16):42-5
 [Biosurgical methods tested in 10 patients. Maggots into the wound--
 do they promote healing?] [Article in German]
 Hinterwimmer S, von Eisenhart-Rothe R, Geisler S, Kessler S.
 Chirurgische Klinik und Poliklinik, LMU Munchen. 
s_hinte...@hotmail.com
  Between 07.04.1999 and 06.07.1999 we used sterile maggots for the
 treatment of 10 patients having acute infections as well as chronic wounds.
 All patients had had unsuccessful treatment for more than six weeks before
 we started our regime. Patients with acute infections and most diabetics
 had the best short-term results. In some diabetics, in chronic arterial
 occlusive disease (stage 4) and in rare cases of chronic infections like
 steroid associated wounds or thrombangitis obliterans The treatment had
 no success or there were complications. The etiologically broad range of
 wounds and our limited experience with biosurgery limit the result of
 our study. In spite of that we regard biosurgery to be a very promising
 part of the range of surgical wound treatment.
 PMID: 11367994
  [9] Arch Phys Med Rehabil 2001 Sep;82(9):1226-9
 Maggot debridement therapy in outpatients.
 Sherman RA, Sherman J, Gilead L, Lipo M, Mumcuoglu KY.
 Department of Medicine, University of California, Irvine,
 CA 92697-4800, USA. Rshe...@UCI.edu
  OBJECTIVE: To identify the benefits, risks, and problems associated with
 outpatient maggot therapy. DESIGN: Descriptive case series, with survey.
 SETTING: Urban and rural clinics and homes. PARTICIPANTS: Seven caregivers
 with varying levels of formal health care training and 21 ambulatory
 patients (15 men, 6 women; average age, 63 yr) with nonhealing wounds.
 INTERVENTION: Maggot therapy. MAIN OUTCOME MEASURE: Therapists' opinions
 concerning clinical outcomes and the disadvantages of therapy. RESULTS:
 More than 95% of the therapists and 90% of their patients were satisfied
 with their outpatient maggot debridement therapy. Of the 8 patients who
 were advised to undergo amputation or major surgical debridement as an
 alternative to maggot debridement, only 3 required surgical resection
 (amputation) after maggot therapy. Maggot therapy completely or
 significantly debrided 18 (86%) of the wounds; 11 healed without any
 additional surgical procedures. There was anxiety about maggots escaping,
 but actual escapes were rare. Pain, reported by several patients, was
 controlled with oral analgesics. CONCLUSIONS: Outpatient maggot debridement
 is safe, effective, and acceptable to most patients, even when administered
 by nonphysicians. Maggot debridement is a valuable and rational treatment
 option for many ambulatory, home-bound, and extended care patients who
 have nonhealing wounds.
 PMID: 11552195
Inoltre su Lancet e su JAMA sono apparsi questi articoli:
 Bonn D.
  Maggot therapy: an alternative for wound infection.
 Lancet. 2000 Sep 30;356(9236):1174. No abstract available.
 PMID: 11030307
 Jarvis A.
  Maggot therapy.
 Lancet. 2000 Dec 9;356(9246):2016. No abstract available.
 PMID: 11130559
 Fitzpatrick M.
  Tiny "surgeons" prove surprisingly effective.
 JAMA. 2000 Nov 8;284(18):2306-7. No abstract available.
 PMID: 11066163
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problema di decubito di mio figlio.
Escludo che sia una soluzione migliore di un trattamento enzimatico ben
fatto con una pomata a base si proteasi, lipasi e desossiribonucleasi.
E' solo una soluzione "diversa", e' sicuramente una soluzione
"stravagante", e ancora piu' sicuramente una soluzione di non facile e
comune applicazione nella gran parte del mondo occidentale.