Maggot therapy (Phaenicia sericata therapy)

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 3-Guanidinopropionic acid, acid-solubilized collagen type I, acid-solubilized collagen type III, aspartyl proteinase, asticot larvae, Biobag, biodebridement, biosurgery, biosurgical debridement, biosurgical management, biosurgical wound debridement, biotherapy, blowfly maggots, Calliphora vicina, Calliphora vomitoria, Calliphoridae (family), carboxypeptidase A, carboxypeptidase B, chymotrypsin I, chymotrypsin-like serine proteinases, dipteran larvae, fibronectin, fly larvae, gold fly, green bottle fly, green bottles, greenbottle larvae, histidine, laminin, larva therapy (LT), larvae, larvae therapy, larval debridement therapy (LDT), maggot therapy, LarveE, leucine aminopeptidase, live maggots, lucifensin, Lucilia ampullacea, Lucilia bufonivora, Lucilia caesar, Lucilia
    defensin, Lucilia eximia Wiedemann, Lucilia illustris Meigen, Lucilia sericata, Lucilia sericata (Meig.), Lucilia sericata (Meigen), Lucilia sericatta, Lucilia silvarum, maggot, maggot chymotrypsin I, maggot debridement therapy, MDT, Medical Maggots™, medicinal maggots, metalloproteinase, musca domestica, Muscina pabulorum, myiasis (infestation of human tissue by fly maggots), myiasis-causing flies, Phaenicia sericata, Phaenicia sericatti, Pharmia regina, Protophormia terraenovae, proteinases, serine proteinases, sheep blowfly, surgical maggots, trypsin, trypsin-like serine proteinases, valinol.


  • Maggot therapy uses live maggots for cleaning wounds that show little or no improvement after four weeks or wounds that do not heal in eight weeks. These types of wounds have a high risk of infection. Phaenicia sericata and Lucilia sericata are species used in maggot therapy.

  • Maggots are fly larvae (the earliest stage of an insect), just as caterpillars are butterfly or moth larvae.

  • Maggot therapy is approved by the U.S. Food and Drug Administration (FDA) for its use in diabetic ulcers (open skin wounds) and wounds after surgery. Maggots are usually placed on the wound with a specific dressing (covering) in order to prevent the maggots from escaping.

  • Maggots have been used to promote wound healing, prevent wound infection, delay wound healing, and prevent bone destruction and other effects due to bacterial bone infection during surgery. They have been used to treat abscesses (collections of pus), bone diseases, burns, gangrene (tissue death), and skin diseases. Maggot therapy has also been studied in other conditions as well. Further studies are needed.


  • Maggots have been used medicinally by ancient healers from Australia, Burma, and Central America. Maggot therapy was often used in India, mainly in rural areas, as it was considered safe, effective, and less expensive than many conventional treatments. Maggot therapy has been shown effective for debriding (removal of infected or dead tissue) foot and leg ulcers in people with diabetes. It is thought that maggot therapy works to aid wound care through debridement, disinfection, and better healing.

  • High-quality scientific information on specific dosing for maggot therapy is lacking. Maggot therapy is usually recommended by a licensed medical doctor, and dressings (coverings) may be applied by a licensed medical doctor, nurses, nursing assistants, physical therapists, or entomologists (insect specialists).

  • Maggots are applied to the wound, using approximately 10 maggots per square centimeter of area. Self-retaining metal or glass devices have been developed to hold wounds open during therapy so as to allow drainage of the wound and provide access to the maggots. Practitioners may expose the maggots, once applied to the skin, to a bright light in order to drive them deeper into the wound.

  • Once the maggots are placed on the wound in a sterile manner, the wound is covered with a little gauze and then a dressing. Wound dressings used in maggot therapy should allow oxygen to reach the maggots, facilitate drainage, allow inspection of the wound, require minimal maintenance, and ideally be low-cost. The dressing is usually removed 1-3 days later, depending upon how fast the maggots mature (once mature, maggots will no longer digest the dead, infected tissue). The dressing is then removed and the wound is rinsed. Once the dressing is removed, maggots will crawl out of the wound and away from the body. If any maggots remain, they can be wiped off with a wet gauze pad.

  • Maggot therapy may need to be repeated once or twice per week until the wound is completely cleaned. Sometimes, one application may be enough. However, rarely, therapy may need to continue for several weeks, depending upon the size of the wound and the amount of dead tissue.

Scientific Evidence


These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Adjunct in surgery (supplementary treatment)

Maggot therapy in plastic surgery and orthopedic surgery has been reviewed. More studies are needed.

Bone diseases (bacterial bone infection)

The use of maggot therapy for osteomyelitis (a bacterial bone infection) has been reviewed. More studies are needed.

Bone diseases (infection in the skull)

Maggot therapy has been studied to treat mastoiditis (bone infection in part of the skull). More high-quality research is needed.


The role of maggot therapy in treating burns has been reviewed. Additional research is needed.

Chronic venous ulcers (open skin wounds)

The role of maggot therapy in treating chronic venous ulcers (chronic open skin wounds on the legs caused by blood flow issues in legs) has been reviewed. More studies are needed.

Diabetic foot ulcers (open skin wounds on the feet)

Maggot therapy has been used to treat diabetic foot ulcers. More studies are needed.

Gangrene (tissue death)

Maggot therapy has been used to treat gangrene (tissue death). More high-quality research is needed.

Leg ulcers (open skin wounds on the legs)

The use of maggot therapy for the treatment of leg ulcers has been reviewed. Maggot therapy had similar health benefits and costs when compared to a common treatment option for leg ulcers (open skin wounds on the legs) called hydrogel. More studies are needed.

Parasite infection (caused a female sandfly)

Maggot therapy may improve scarring and wound healing in patients with leishmaniasis ulcers (open skin wounds caused by the bite of a certain female sandfly). Additional research is needed.

Pressure ulcers (open skin wounds caused by rubbing against the skin)

The use of maggot therapy has been used to treat pressure ulcers (open skin wounds caused by frequent rubbing or pressure against the skin). More studies are needed.

Skin diseases (calcium buildup in small blood vessels found in fat and skin tissue)

The use of maggot therapy to treat calciphylaxis (calcium buildup in small blood vessels found in fat and skin tissue) has been reported. Additional research is needed.

Skin graft healing (skin transplant failure)

Maggot therapy has been used for skin graft failure (skin transplant failure). More high-quality research is needed.

Surgery (alternative)

The use of maggot therapy as an alternative to surgery has been reviewed. More studies are needed.

Ulcers (open skin wounds)

Maggot therapy has been used to treat ulcers. More high-quality research is needed.

Wound healing

The effectiveness of maggot therapy in the debridement of chronic wounds and severe skin infections has been reviewed. Additional research is needed.

*Key to grades:


The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Antibacterial, cancer, bacterial skin infection, nerve regeneration, ostomy care (surgical opening to remove bodily wastes), soft tissue injuries, tumors (necrotic), vasculitis (Churg-Strauss syndrome), venous disorders (venous stasis wounds).


Los profesionales de la salud que tienen instrucción formal practican muchas técnicas complementarias, de acuerdo con los estándares de organizaciones nacionales. No obstante, este no es el caso universal; es posible que se presenten efectos adversos. Debido a la limitada investigación existente, en algunos casos solamente hay poca información disponible sobre la seguridad del tratamiento.

  • Avoid with known allergy to soybean, fly larvae, egg, yeast, or adhesive allergies.

  • Maggot therapy may affect the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Use cautiously in people with a lack of wound hemostasis (the first stage of wound healing that stops bleeding), and those with deep tracking wounds, coagulopathies (clotting disorders), osteomyelitis (a bacterial bone infection) or serious infections, hypersensitivity to movement, or psychological issues.

  • Use cautiously, due to the potential for increased pain, as shown in people with leg ulcers associated with ischemic disease.

  • Use cautiously in people with anxiety, as anxiety has been associated with thoughts of the maggots escaping.

  • Fever and flu-like symptoms have been reported with maggot therapy.

  • Avoid use in pregnant or breastfeeding women, due to a lack of safety information.

  • Avoid use of nonsterile maggots (those not produced in laboratories or medical centers under controlled disease-free conditions), based on the potential for septicemia (blood infection).

  • Avoid with known allergy to soybean, fly larvae, egg, yeast, or adhesive allergies.

  • Maggot therapy may alter the risk of bleeding when taken with drugs that alter the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Maggot therapy may interact with agents that suppress the immune system, antibiotics, anti-inflammatories, and hydrogel (a type of wound dressing).

  • Maggot therapy may alter the risk of bleeding when taken with herbs and supplements that are believed to alter the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Maggot therapy may also interact with Anethum graveolens, antibacterials, anti-inflammatories, celery, Chenopodium ambrosioides, Conyza dioscoridis, fenugreek, herbs and supplements that suppress the immune system, hydrogel (a type of wound dressing), Mentha microphylla, mustard, and radish.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (


Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to Selected references are listed below.

  1. Lewis R, Whiting P, ter Riet G, et al. A rapid and systematic review of the clinical effectiveness and cost-effectiveness of debriding agents in treating surgical wounds healing by secondary intention. Health Technol.Assess. 2001;5(14):1-131. View Abstract
  2. Horn KL, Cobb AH Jr, Gates GA. Maggot therapy for subacute mastoiditis. Arch.Otolaryngol. 1976;102(6):377-379. View Abstract
  3. Mumcuoglu KY, Lipo M, Ioffe-Uspensky I, et al. [Maggot therapy for gangrene and osteomyelitis]. Harefuah 3-2-1997;132(5):323-5, 382. View Abstract
  4. Namias N, Varela JE, Varas RP, et al. Biodebridement: a case report of maggot therapy for limb salvage after fourth-degree burns. J.Burn Care Rehabil. 2000;21(3):254-257. View Abstract
  5. Wayman J, Nirojogi V, Walker A, et al. The cost effectiveness of larval therapy in venous ulcers. J.Tissue Viability. 2000;10(3):91-94. View Abstract
  6. Eneroth M and van Houtum WH. The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers. Diabetes Metab Res.Rev. 2008;24 Suppl 1:S76-S80. View Abstract
  7. Nordstrom A, Hansson C, Karlstrom L. Larval therapy as a palliative treatment for severe arteriosclerotic gangrene on the feet. Clin.Exp.Dermatol. 2009;34(8):e683-e685. View Abstract
  8. Dumville JC, Worthy G, Bland JM, et al. Larval therapy for leg ulcers (VenUS II): randomised controlled trial. BMJ 2009;338:b773. View Abstract
  9. Arrivillaga J, Rodriguez J, Oviedo M. [Preliminary evaluation of maggot (Diptera: Calliphoridae) therapy as a potential treatment for leishmaniasis ulcers]. Biomedica. 2008;28(2):305-310. View Abstract
  10. Sherman RA, Wyle F, Vulpe M. Maggot therapy for treating pressure ulcers in spinal cord injury patients. J.Spinal Cord.Med. 1995;18(2):71-74. View Abstract
  11. Picazo M, Bover J, de la Fuente J, et al. [Sterile maggots as adjuvant procedure for local treatment in a patient with proximal calciphylaxis]. Nefrologia. 2005;25(5):559-562. View Abstract
  12. Gericke A. and Pitz S. Maggot therapy for periocular skin graft failure in the immunocompromised patient. Br.J.Ophthalmol. 2008;92(6):860-861. View Abstract
  13. Steenvoorde P, van Doorn LP, Jacobi CE, et al. Maggot debridement therapy in the palliative setting. Am.J.Hosp.Palliat.Care 2007;24(4):308-310. View Abstract
  14. Steenvoorde P, Jacobi CE, Van Doorn L, et al. Maggot debridement therapy of infected ulcers: patient and wound factors influencing outcome – a study on 101 patients with 117 wounds. Ann.R.Coll.Surg.Engl. 2007;89(6):596-602. View Abstract
  15. Hall S. A review of maggot debridement therapy to treat chronic wounds. Br.J.Nurs. 8-12-2010;19(15):S26, S28-S26, S31. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.