Yes, you read that right. The U.S. Food and Drug Administration (FDA) has given a green light to the larvae of Lucilia cuprina, commonly known as the Australian sheep blowfly, for use in maggot wound therapy.
That appears to make it the second fly species cleared by the FDA to help clean dead skin from chronic wounds. The other is Lucilia sericata, also known as the common green bottle fly, which was first cleared for use by the agency in 2004.
Cuprina Holdings, a biomedical company that makes products for chronic wound care, last week announced that its treatment MEDIFLY Maggots had received FDA 510(k) clearance to use Lucilia cuprina larvae. These specific maggots were approved to remove dead tissue from chronic wounds, including pressure ulcers, diabetic foot ulcers, and wounds that have not healed after an injury or surgery.
Known as maggot debridement therapy, the treatment works by applying medical-grade, sterile fly larvae to a wound under the supervision of trained healthcare professionals. According to Cuprina, the maggots secrete enzymes that break down dead tissue, turning it into a liquid that the larvae then eat.
To be clear, the maggot species used for this therapy primarily feed on carrion, or dead and rotting flesh. That is different from parasitic fly species like the New World screwworm, whose larvae feed on living flesh and recently made its way back to the U.S.
How maggot debridement therapy works
While the image of Lucilia cuprina used for this story features a grown fly, health care providers use maggots, a larva of a fly, to carry out the treatment. As noted by the UK’s NHS, the maggots used in this therapy are only a few millimeters long, smaller than a grain of rice, though will increase in size to about 12 mm during the treatment.
Maggots can be applied using a special dressing, where they remain sealed, that manages the exudate, the fluid secreted by the maggots and the person’s own body to help clean out the wound. Another option is applying the maggots directly onto the wound and keeping them there with dressing. Maggot debridement therapy normally lasts a few days, though some wounds may require multiple rounds of treatment to achieve the desired results.
Not a new therapy
Maggots have been used to treat wounds for centuries, with evidence of the treatment being used in ancient cultures like the Mayans in Central America. There is even documentation of this practice being used during the American Civil War. However, while a systematic review published last year found that maggot debridement therapy can help chronic wounds clear out dead tissue faster, the authors found that it did not clearly improve overall healing compared with conventional treatments.
“Maggot debridement therapy has earned its place in modern wound care, and adding a second FDA-cleared species strengthens the entire field,” said Cuprina Medical and Scientific Director Dr. Ronald Sherman in a press release.
The company also said that, to its knowledge, it is now the only one with FDA clearance for both maggot species used in this therapy. Cuprina says that could help it serve different markets as Lucilia sericata is better known in Western wound care, while Lucilia cuprina is more familiar in many warmer regions.
