Hybrid approach in sacral sore management with maggot debridement therapy and flap reconstruction

Marvin Man Ting Chung; Samuel Yan Jin Fang; Alex Pat Chung Yeung; Wai Fung Kwong; Yuk Fai Lui; Wing Yuk Ip

doi:10.1016/j.jpra.2023.12.006

Hybrid approach in sacral sore management with maggot debridement therapy and flap reconstruction

JPRAS Open. 2023 Dec 6:39:95-100. doi: 10.1016/j.jpra.2023.12.006. eCollection 2024 Mar.

Authors

Marvin Man Ting Chung¹, Samuel Yan Jin Fang², Alex Pat Chung Yeung², Wai Fung Kwong², Yuk Fai Lui¹, Wing Yuk Ip¹

Affiliations

¹ Department of Orthopaedics & Traumatology, University of Hong Kong, Hong Kong.
² Department of Orthopaedics & Traumatology, Queen Mary Hospital, Hong Kong.

Abstract

Sacral sore is a common problem in patients with spinal cord injury. It leads to prolonged hospitalization and recurrent infections which might require repeated surgery to treat. Flap reconstruction allows soft tissue coverage of sacral sore under the premise of infection-free wound base. Maggot debridement therapy (MDT) has been described as an alternative non-surgical management as opposed to the traditional surgical debridement in case of infected sore, reducing number of surgeries under anaesthesia. However, MDT and surgery are not mutually exclusive. In this article we describe a hybrid approach combining MDT and flap reconstruction with multi-disciplinary effort in management of sacral sore, which accelerates wound healing and prevents morbidities, while lowering the risks associated with repeated surgical debridement at the same time.

Keywords: Decubitus ulcer; Flap reconstruction; Maggot debridement; Pressure sore; Sacral sore.