Efficacy of maggot debridement therapy on refractory leg ulcers of Behçet Disease: an open-label study

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Background

Cutaneous ulcers of Behçet disease (BD) are rare but have high morbidity and resistance to conventional therapies. An important and essential aspect of ulcer management is debridement. Regarding maggot therapy (MT), excretions of green bottle fly, Lucilia sericata, are able to remove necrotic debris and promote healing.

Aim

With this study, we aimed to evaluate the efficacy of MT for cutaneous ulcers of BD.

Methods

In this open‐label trial, BD patients with refractory leg ulcers suitable for MT were enrolled. Maggot application was performed until complete debridement was achieved and all patients were followed‐up for 12 months afterwards, to assess the total healing of ulcers.

Results

Twenty‐four patients with 32 wounds were enrolled and 91,6% of all ulcers were completely debrided. Average time to debridement was 14.9 days and average number of cycles required was 5.3. Average ulcer size was decreased by 23% with treatment. Time to debridement was positively correlated with pre‐treatment ulcer size and duration of ulcer (p=0.00 and p=0.004) but wound depth, comorbidities, smoking, age or gender were not correlated with debridement time (p>0.05). During follow‐up, 79.1% of all ulcers healed completely. Duration of the wound, pre‐ and post‐treatment ulcer area and wound depth were positively correlated with average time required for total healing (p=0.027, p=0.00, p=0.041). Average time to total debridement was positively correlated with total healing time (p=0.007).

Conclusions

The findings presented in this first and unique study may provide key answers about factors affecting success rate of MT in BD cutaneous ulcers.



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