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Larval Debridement Therapy Effective for Leg Ulcers

Health benefits, treatment costs are similar to those for standard hydrogel debridement therapy

FRIDAY, March 20 (HealthDay News) -- In patients with sloughy or necrotic leg ulcers, debridement with larval therapy leads to similar outcomes at a similar cost as standard hydrogel therapy, but it may be associated with reduced time to debridement and more pain, according to two studies published March 19 in BMJ Online First.

In one study, Jo C. Dumville, a research fellow at the University of York in the United Kingdom, and colleagues randomly assigned 267 patients to receive treatment with either larval therapy or standard hydrogel therapy. Compared to standard therapy, the investigators found that larval therapy was not associated with an improved healing rate or reduced bacterial load, but that it was associated with a significantly decreased time to debridement (mean 2.31 days) and significantly higher mean ulcer-related pain scores.

In a second study, Marta O. Soares, also a research fellow at the University of York, and colleagues conducted a cost-effectiveness analysis in the same group of patients and found that there were no statistically significant group differences in cost per ulcer-free day and incremental costs per quality-adjusted life years.

"It could be argued that health care decision makers should be indifferent when recommending these two therapies for the treatment of sloughy or necrotic leg ulcers or that the decision should be driven by the goal of treatment (for example, if debriding an ulcer rapidly is important when a skin graft is planned)," Soares and colleagues conclude. "The choice of treatment may then be driven by patients' wishes and experiences of pain with larvae."

Abstract - Dumville
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Abstract - Soares
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