Author/Editor		Jaklič, Domen; Zupančič, Klemen; Lapanje, Aleš; Smrke, Dragica; Cimerman, Matej; Parać, Zlatko; Arnež, Zoran; Gunde-Cimerman, Nina
Title		Uvedba zdravljenja kroničnih ran z ličinkami muh Lucilia sericata v Slovenijo
Translated title		Introduction of chronical wounds healing with Lucilia sericata larvae in Slovenia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 77, št. 3
Publication year		2008
Volume		str. 199-206
Language		slo
Abstract		Background Due to infection of chronic wounds with antibiotic resistant bacterial strains, their healing can be very difficult. The main purpose of the presented research study was the introduction of a new method for chronic wounds healing, using Lucilia sericata fly larvae into Slovenia. Methods For chronic wound healing sterile larvae of L. sericata fly were prepared from a continuous fly culture, maintained at the Department of Biology, Biotechnical Faculty, University of Ljubljana. In this way 32 wounds of 30 patients were treated. Larvae were applied on the wounds for two to three days. Than they were washed off and replaced, if necessary. Microbiological smears were collected before and after the application of the larvae on the wounds. Microorganisms were then isolated and identified. During larval therapy healing improvement, patient’s general state, potential presence of pain, mobility, patient’s independence and psychological reaction to the therapy were monitored. Results Using biosurgical therapy 24 (75%) out of 32 wounds were cleaned and healed. In the case of combined arterio-venous leg ulcers one wound was completely healed and eight of them were cleaned of necrosis and infection. In the case of a venous leg ulcer, six diabetic ulcers, eight cases of chronic postoperative wounds and pressure ulcers, wounds were completely cleaned after the treatment. 16 patients reported unpleasant feeling during larval treatment and two patients felt pain which diminished after the treatment with analgesics. 17 (57%) patients had to use crutches during biosurgical treatment and the same number of patients felt uncomfortable, frightened and depressed during the application of larvae.
Summary		Izhodišča Ker so kronične rane danes pogosto okužene z bakterijskimi sevi, odpornimi na antibiotike, je njihovo zdravljenje težavno. Namen raziskovalnega projekta je bil uvesti v Slovenijo novo metodo zdravljenja kroničnih ran z uporabo ličink muh Lucilia sericata. Metode Za zdravljenje kroničnih ran smo uporabili sterilne larve L. sericata, pridobljene v kontinuirani kulturi na Oddelku za biologijo Biotehniške fakultete UL. Na ta način smo zdravili 32 ran pri 30 bolnikih. Ličinke smo na rani pustili delovati dva do tri dni; nato smo jih odstranili in po potrebi ponovno namestili. Pred namestitvijo in po njej smo jemali mikrobiološke brise tkiva v rani in iz njih osamili ter identificirali bakterijske vrste. Med biokirurškim zdravljenjem smo spremljali potek zdravljenja, bolnikovo počutje, morebitne bolečine, pokretnost, samostojnost in psihološki odziv ob terapiji. Rezultati Z biokirurškim zdravljenjem smo uspeli zaceliti in očistiti 24 ran od 32 (75%). V primeru kombinirane arterijsko-venske razjede smo uspeli popolnoma zaceliti eno rano in očistiti 8 ran, v primeru venske razjede na nogi in šestih diabetičnih razjed so se vse rane očistile. V primerih preležanin in pooperativnih kroničnih ran smo z biokirurgijo vse rane v celoti očistili. 16 bolnikov je med nošenjem ličink občutilo neprijeten občutek, pri dveh so se pojavile bolečine, ki so se po dodatku analgetikov pomirile. Med zdravljenjem si je pri hoji z berglami pomagalo 17 (57%) bolnikov. Ugotovili smo, da je 17 bolnikov (57%) čutilo strah in depresijo ter nelagoden občutek. Zaključki Metoda zdravljenja z ličinkami muhe L. sericata je bila uspešno uvedena v Slovenijo. Zaradi enostavnosti in uspešnosti bi jo bilo potrebno kot način zdravljenja uvesti tudi v vsakdanjo slovensko klinično prakso. Z biokirurgijo se kronične rane hitreje celijo, preprečimo nadaljnja vnetja in propadanje tkiva ter bolniku omogočimo normalno vključevanje v vsakdanje življenje.
Descriptors		WOUND HEALING LARVA TREATMENT OUTCOME DIPTERA