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

Sacral sores are a frequent issue for individuals with spinal cord injuries, often leading to extended hospital stays and recurring infections that may necessitate repeated surgical interventions. Flap reconstruction offers soft tissue coverage for sacral sores, but it requires a wound base free from infection. Maggot debridement therapy (MDT) is presented as a non-surgical alternative to traditional surgical debridement for infected sores, aiming to reduce the number of surgeries needed. MDT involves using sterile larvae to remove necrotic tissue, promoting the growth of granulation tissue. The described hybrid approach combines MDT and flap reconstruction, promoting faster wound healing and preventing complications, while also reducing the risks associated with repeated surgical debridement. This approach seeks to balance infection clearance with the need for soft tissue coverage in vulnerable patients.

• 1
  The hybrid approach, combining maggot debridement therapy (MDT) and flap reconstruction, accelerates wound healing in sacral sores.
• 2
  MDT facilitates better wound bed preparation by debriding necrotic tissues, reducing the need for multiple surgeries and associated risks.
• 3
  Early flap reconstruction, following MDT, promotes faster wound coverage once the infection is controlled and a healthy wound bed is achieved.