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Increase in skin perfusion pressure after maggot debridement therapy for critical limb ischaemia
Author(s) -
Maeda T. M.,
Kimura C. K.,
Takahashi K. T.,
Ichimura K. I.
Publication year - 2014
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.12454
Subject(s) - medicine , debridement (dental) , perfusion , amputation , surgery , ischemia , negative pressure wound therapy , catheter , limb perfusion , critical limb ischemia , wound healing , subcutaneous tissue , soft tissue , foot (prosody) , vascular disease , pathology , arterial disease , alternative medicine , linguistics , philosophy
Summary Skin perfusion pressure ( SPP ) is the perfusion pressure at the skin level, and it can serve as an index of peripheral circulation in the skin and subcutaneous tissue. We report a 78‐year‐old man with critical limb ischaemia who, despite having undergone several catheter interventions, still had severe ulcers with exposed bone on his right foot. We performed transmetatarsal amputation. The tissue around the surgical site became necrotic several days later, and did not respond to conservative therapy. Therefore, we opted for maggot debridement therapy ( MDT ), given that maggots favour necrotic tissue. After the therapy, SPP around the ulcer increased from 12 to 54 mmHg on the dorsal aspect, and from 17 to 44 mmHg on the plantar aspect. Wound healing was successfully activated by MDT , leading to complete healing within 2.5 months after MDT . We believe that MDT probably contributed to increase the blood supply to the ischaemic wound.