Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer

Treating injuries on the shoulder and leg caused by electrical shock using a combination of wound care techniques: A case report

INTRODUCTION AND IMPORTANCE

Electrical injuries involve complex tissue damage and varied wound patterns, requiring a deep understanding of their pathophysiology for effective management. They often affect critical areas like the shoulder and leg, complicating treatment and necessitating specialized care plans for optimal healing.

CASE PRESENTATION

We report a 42-year-old male with severe lacerations and tissue damage from a high-voltage power line accident. Immediate intervention included surgical debridement, antimicrobial therapy, and advanced wound care.

CLINICAL DISCUSSION

A multidisciplinary team developed a tailored rehabilitation strategy, emphasizing collaborative care's role in successful recovery. The effective closure of wounds and functional restoration highlights the need for specialized approaches in managing electrical injuries.

CONCLUSION

This case underscores the complexities of treating electrical injuries and the importance of a coordinated, multidisciplinary approach for optimal healing and patient outcomes.

The effect of a stress ball on pain and anxiety during sharp debridement in patients with diabetic foot ulcers: A randomized controlled, single-blind study

OBJECTIVE

The aim of this study was to investigate the effect of using a stress ball during sharp debridement on the pain and anxiety in patients with diabetic foot ulcers.

METHODS

This study with a randomized, controlled and single-blind design was conducted at a single-center on patients diagnosed with diabetic foot ulcers who were being treated at the endocrinology and metabolic diseases clinic of a university hospital. Patients in the intervention group started using a stress ball before the debridement procedure and continued to use it until the procedure ended. No intervention was made to the patients in the control group. Data were collected by using the Descriptive Information Form, Diabetic Foot Meggit-Wagner Classification, Visual Analogue Scale (VAS), and State Anxiety Inventory (STAI).

RESULTS

The study was completed with a total of 76 patients, 38 each in the intervention and control groups. The use of stress balls led to a reduction in anxiety and pain symptoms in the intervention group. The anxiety score of the patients in the intervention group was also found to be statistically significantly lower than those in the control group after the procedure (p = 0.008; η2 = 0,091). The VAS scores of the patients in the intervention group were found to be statistically significantly lower than those in the control group both during (p < 0.001; η2 = 0.348) and after (p < 0.001; η2 = 0.438) the procedure.

CONCLUSIONS

The use of a stress ball was found to be an effective method of reducing the level of pain and anxiety that occurs during the sharp debridement procedure. Stress ball application is a practical, easy, and cost-effective non-pharmacological method.

CLINICAL TRIAL NUMBER

The study was recorded in the ClinicalTrials.gov website with the number NCT06316115.

Surgical sharp debridement alongside maggot debridement therapy (MDT) for the treatment of diabetic foot ulcers (DFUs): A systematic review of case reports

Objective

The objective of this systematic review of case reports is to evaluate the efficacy and safety of combining surgical sharp debridement with maggot debridement therapy (MDT) for the treatment of diabetic foot ulcers (DFUs).

Methods

A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, and Web of Science. Inclusion criteria were studies that reported on the use of surgical sharp debridement alongside MDT for DFUs, while exclusion criteria included insufficient detail on treatment methods or patient outcomes, non-human studies, and non-English publications. Data were extracted using a standardized form, and the quality of case reports was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports. A narrative synthesis was conducted due to the anticipated heterogeneity of the case reports, and a sensitivity analysis was performed to assess the robustness of the findings.

Results

The review process began with 1003 records, which were narrowed down to 721 unique records after removing duplicates. Following title and abstract screening, and full-text assessment, 8 studies were selected for inclusion in the final analysis. The narrative synthesis identified several key findings, including significant wound size reduction, improved glycemic control, disappearance of foul odor, improved healing rates, infection control, granulation tissue formation, epithelialization, complete wound closure, avoidance of amputation, and pain alleviation. The combination therapy showed promise in managing DFUs effectively.

Conclusion

The systematic review of case reports presents evidence supporting the combined use of surgical sharp debridement and maggot debridement therapy in the management of diabetic foot ulcers. The findings suggest that this approach can lead to successful wound healing and limb preservation, offering a valuable addition to the clinician's toolkit for treating DFUs.

Surgical management of a massive omphalocele in a newborn: A case report study

INTRODUCTION AND IMPORTANCE

Omphalocele is a rare congenital defect in the abdominal wall, affecting about 1 in 5000 to 10,000 newborns. It occurs when abdominal organs protrude through an opening at the base of the umbilical cord. Treating massive omphaloceles is highly challenging, requiring innovative and staged surgical methods to avoid complications like increased intra-abdominal pressure and potential organ damage.

CASE PRESENTATION

A female newborn with a 12.5 cm omphalocele was delivered emergently via cesarean section due to fetal distress. The exposed organs, including parts of the intestines and liver, were covered by a thin membrane. To minimize complications, a staged approach was opted for: first, a silo was placed to gradually reduce the herniated organs, followed by closure of the abdominal wall with absorbable sutures and biologic mesh.

CLINICAL DISCUSSION

Omphalocele in newborns is a serious congenital defect where abdominal organs protrude through the umbilical cord, covered by a membrane. It requires urgent medical care to prevent complications like respiratory distress and infections. Treatment typically involves a team of pediatric surgeons and staged surgeries to repair the defect and ensure the infant's long-term health.

CONCLUSION

The successful staged surgical method of silo reduction and biologic mesh for this massive omphalocele highlights the need for personalized surgical planning and multidisciplinary care. Six months later, the patient is thriving, showing no signs of recurrence or complications.

Electrospun Nanofibers from Plant Natural Products: A New Approach Toward Efficient Wound Healing

Globally, wound care has become a significant burden on public health, with annual medical costs reaching billions of dollars, particularly for the long-term treatment of chronic wounds. Traditional treatments, such as gauze and bandages, often fail to provide an ideal healing environment due to their lack of effective biological activity. Consequently, researchers have increasingly focused on developing new dressings. Among these, electrospinning technology has garnered considerable attention for its ability to produce nano-scale fine fibers. This new type of dressing, with its unique physical and chemical properties-especially in enhancing breathability, increasing specific surface area, optimising porosity, and improving flexibility-demonstrates significant advantages in promoting wound healing, reducing the risk of infection, and improving overall healing outcomes. Additionally, the application of natural products from plants in electrospinning technology further enhances the effectiveness of dressings. These natural products not only exhibit good biocompatibility but are also rich in pharmacologically active ingredients, such as antibacterial, anti-inflammatory, and antioxidant compounds. They can serve as both the substrate for nanofibers and as bioactive components, effectively promoting cell proliferation and tissue regeneration, thereby accelerating wound healing and reducing the risk of complications. This article reviews the application of plant natural product nanofibers prepared by electrospinning technology in wound healing, focussing on the development and optimisation of these nanofibers, discussing the advantages and challenges of using plant natural products in this technology, and outlining future research directions and application prospects in this field.

Healing of a diabetic foot wound through surgical debridement using med-honey, maggot therapy, and human amniotic membrane: A case study

INTRODUCTION AND IMPORTANCE

Diabetic foot ulcers (DFUs) are a common and challenging issue for individuals with diabetes, creating difficulties in effective wound healing and requiring novel treatment methods.

CASE PRESENTATION

The individual, a 46-year-old man, arrived at our clinic with a pressure wound concern. The wound had progressed to where necrotic tissue removal was necessary, accomplished through four sessions of maggot therapy. Following this initial treatment, Med-honey dressing and human amniotic membrane application were used in eight subsequent sessions, resulting in the successful closure of the wound.

DISCUSSION

Treating DFUs presents a significant hurdle in medical practice due to their intricate nature and potential complications. Recent years have seen an increase in the exploration of unconventional and innovative therapies to enhance wound healing outcomes and tackle the multifaceted challenges linked with DFUs.

CONCLUSION

The effective management of the pressure wound in this 46-year-old male patient with a combination of maggot therapy, Med-honey dressing, and human amniotic membrane application highlights the significance of a personalized and interdisciplinary approach in DFUs care.

Comprehensive infectious diabetic foot ulcer repair through multiple dressing methods, maggot therapy, and vacuum therapy after amputation: A case report study

INTRODUCTION AND IMPORTANCE

Diabetic foot ulcers are a prevalent and challenging issue among diabetes patients, frequently leading to notable health concerns and reduced quality of life. Effectively addressing diabetic foot ulcers necessitates a comprehensive treatment strategy.

CASE PRESENTATION

The 69-year-old patient with Type 2 diabetes, complicated by illiteracy and poor glycemic control, developed a foot wound that escalated to cellulitis and abscess due to diabetes and peripheral vascular disease. After angioplasty and midfoot amputation, treatment focused on wound healing with antibiotics, local anesthesia, larval therapy, vacuum-assisted closure (VAC), platelet-rich plasma (PRP) injections, and specialized dressings. A multidisciplinary team approach facilitated successful wound healing and functional improvement, highlighting the importance of comprehensive care and innovative treatments in complex diabetic foot ulcers.

DISCUSSION

Diabetic foot ulcers, a frequent complication of diabetes, present notable hurdles in treatment and care. Comprehensive strategies are typically essential for managing these ulcers efficiently and averting additional issues. Recently, there has been increasing attention towards employing various dressing techniques, maggot therapy, and vacuum therapy as integral components of a holistic diabetic foot ulcer treatment approach.

CONCLUSION

Employing a comprehensive method involving various dressing techniques, maggot therapy, and vacuum therapy for diabetic foot ulcers can significantly boost wound healing, curb infections, and lower the chances of additional complications.

The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report

INTRODUCTION AND IMPORTANCE

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma (MFH), is a highly aggressive soft tissue sarcoma characterized by its pleomorphic histology and lack of differentiation.

CASE PRESENTATION

A 35-year-old man visited our oncology department with a complaint of a growing mass in his left buttock area. The mass had been increasing in size for the past six months, affected by local and systemic infection. While it was initially painless, the patient started feeling discomfort during sitting and physical activities a few weeks, but later the complication of tumor became more aggressive.

CLINICAL DISCUSSION

UPS can arise in various anatomical sites, including the extremities, trunk, retroperitoneum, and head and neck region. Clinically, UPS may present as a rapidly growing mass, often with pain and limited range of motion. However, the presentation may vary depending on the site of origin. Treatment for UPS typically involves surgical resection, aiming to remove the tumor completely. Depending on the size, location, and aggressiveness of the tumor, additional treatments such as radiation therapy or chemotherapy may be recommended.

CONCLUSION

Undifferentiated pleomorphic sarcoma (UPS) represents a rare and aggressive soft tissue sarcoma requiring prompt and accurate diagnosis for appropriate management. With its non-specific clinical presentation and histological features, UPS can be challenging to differentiate from other soft tissue tumors.