Maggot therapy

Definition

The controlled clinical application of live, disinfected fly larvae (maggots) to necrotic or infected wounds to selectively debride dead tissue, suppress bacterial growth, and promote healing. The larvae of blow flies (Calliphoridae), particularly Lucilia sericata, are most commonly used for their proteolytic secretions that liquefy necrotic tissue while sparing healthy tissue, and for their antimicrobial compounds that reduce pathogen load.

Etymology

From 'maggot' (Middle English magot, of uncertain origin, denoting a soft-bodied larva) + 'therapy' (Greek therapeia, healing treatment).

Example

In diabetic foot ulcers with extensive necrosis, maggot therapy using sterile Lucilia sericata larvae can debride slough more precisely than surgical sharp debridement while simultaneously reducing methicillin-resistant Staphylococcus aureus (MRSA) colonization through larval secretions containing antibacterial peptides.

Synonyms

• Maggot debridement therapy (MDT)
• Larval therapy
• Biosurgery
• Biodebridement

Related Terms

• Debridement
• Myiasis
• Calliphoridae
• Lucilia sericata
• Wound healing
• Antimicrobial peptides
• Medical entomology
• Sterile insect technique

Usage Notes

Distinguished from accidental myiasis (parasitic fly larval infestation) by its controlled, therapeutic intent and use of disinfected, laboratory-reared larvae. The term 'larval therapy' is sometimes preferred in clinical contexts to avoid patient aversion to 'maggot,' though 'maggot therapy' remains standard in entomological and medical literature. Effectiveness varies by wound type; contraindicated in wounds with exposed blood vessels, fistulas, or coagulopathy. Regulatory classification differs by jurisdiction—some treat medicinal maggots as medical devices, others as medicinal products.