Akademik Veri Yönetim Sistemi
Tezin Türü: Yüksek Lisans
Tezin Yürütüldüğü Kurum: İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Türkiye
Tezin Onay Tarihi: 2023
Tezin Dili: Türkçe
Öğrenci: Emrah Gürel
Danışman: Erdal Polat
Özet:
Larva
debridement therapy (LDT) debride the necrotic tissues by the enzymes of Lucilia sericata I. and II. larvae. Larva
can dissolve necrotic tissues in chronic wounds by dissolving and digesting
them, disinfect the wound, and stimulate the tissue to form granulation. In
this study, the aim was to
evaluate retrospectively the bacteria existing in biopsies of necrotic
ulcerated or purulent wounds of patients undergoing LDT and to determine the
most common bacteria to be combated
during LDT.
Chronic wound biopsies of 100 patients who were sent
to TÜBİTAK Biotherapy Research and Development Laboratory with the request of
LDT, were analysed bacteriologically in the Medical Microbiology Laboratory
of Cerrahpasa Medical Faculty Hospital. Biopsies cultures collected from the
same area before the first LDT and after the 3rd LDT were made, bacteria were
identified using conventional methods and MALDI TOF- MS. The density of
bacteria grown in culture media was determined by semi-quantitative counting
and scoring as 1+, 2+, 3+ and 4+. The results were evaluated statistically.
From wound
biopsies, 51 were diabetic foot ulcers, 38 were pressure ulcers, and 11 were
venous ulcers. After 3rd LDT, the number of biopsies with 4+ growths in
diabetic foot ulcers and 3+ growths in pressure ulcers were significantly decreased (p< 0.05), the number of biopsies with
1+ growth was significantly increased (p< 0.05). After the 3rd LDT a statistically
significant decrease was found in the rates of S. pyogenes, S. galactiae, E. cloacae and M. morgani in diabetic foot ulcers, and in the rates of S. pyogenes, S. galactiae, C. striatum, P. vulgaris and M. morgani in pressure ulcers compared
with their rates obtained before LDT (p<0.05), A significant difference
was not found in venous ulcers.
With LDT,
some of the microorganisms that reproduce in the ulcers disappear or
decrease, but ensuring wound healing with bacteria that periste indicates the
need for long-term treatments.