Resumen de Experiencia de terapia larval en pacientes con úlceras crónicas

Luis Figueroa, Fernando Uherek, Pedro Yusef, Liliana López, Jordana Flores

• español

  Se utilizaron larvas estériles de moscas con el fin de limpiar 5 lesiones ulcerosas (3 úlceras sacras, 1 trocantérea y 1 pie diabético), en cuatro pacientes del Servicio de Cirugía del Hospital Regional de Valdivia. Los pacientes seleccionados firmaron un consentimiento informado. Las larvas estériles se obtuvieron de huevos de mosca Lucilia sericata, que fueron esterilizados en hipoclorito de sodio de 0,5% y formalina de 10%, comprobando su desinfección con cultivos negativos en agar sangre y caldo triptosa. Las larvas se depositaron en la úlcera (5-10 larvas / cm² de superficie), protegiendo la piel circundante con un apósito adhesivo. La fuga de larvas se impidió con una malla fina de nylon. El exudado producido fue absorbido por gasas que se cambiaron entre 2 a 3 veces al día. Las úlceras se limpiaron totalmente con 1 a 6 aplicaciones de larvas, el olor desapareció luego de la primera aplicación en todos los pacientes. Hubo fuga de larvas en todos los pacientes en las etapas iniciales de cada tratamiento. Sólo un paciente manifestó sensación de cosquilleo por las larvas. El método propuesto puede ser de utilidad para limpiar úlceras crónicas, en pacientes cuyas curaciones diarias no logran mejoría

• English

  The technique of maggot therapy was applied for the first time in Chile in an attempt to duplicate beneficial results of this method as reported in the literature. Microbiologically sterile fly larvae were used to clean five ulcerative lesions (three sacral, one trocantral, and one diabetic foot) in four patients in the Surgical Service of the Valdivia Regional Hospital. The selected patients signed informed consent release papers permitting the therapy. The sterile larvae were obtained from the eggs of Lucilia sericata flies which had been treated with 0.5% sodium hypochlorite followed by 10% formalin, with sterility proved by negative results of inoculations of eggs onto blood agar and into tryptose broth. The larvae were deposited onto ulcers at 5-10 larvae per cm² of surface, protecting adjacent healthy skin with an adhesive tape shield. Escape of the larvae was prevented by overlaying the preparation with fine nylon screen. The exudate from the preparation was absorbed by gauze pads which were changed 2-3 times a day. The ulcers treated were totally cleaned after 1-6 applications of larvae, and odors disappeared after the first larval application in all patients. There was some escape of larvae in all patients in the initial stages of the treatment. Only one patient experienced a tickling sensation due to the larvae. The method proposed here may be of great use for the cleaning of chronic ulcers in patients who show no improvement from routine daily treatment of the ulcers