The FDA Clears Wound Treatment Made of Live Hungry Maggots For Second Time

Australian sheep blowfly larvae join a small but stubborn corner of wound care.

The newest wound-care tool cleared by federal regulators is alive, hungry, and smaller than a grain of rice.

The Food and Drug Administration has granted 510(k) clearance to MEDIFLY Maggots, a treatment made from sterile larvae of Lucilia cuprina, the Australian sheep blowfly. The larvae can now be used to remove dead tissue from chronic wounds, including pressure ulcers, diabetic foot ulcers, and stubborn wounds left after injury or surgery.

The decision makes L. cuprina the second fly species cleared in the United States for maggot debridement therapy, after Lucilia sericata, the common green bottle fly, received clearance in 2004.

A Remedy Older than Antibiotics

Maggot therapy sounds like a medieval holdover. In some ways, it is.

Doctors and healers have used fly larvae to treat wounds for centuries, with reports reaching back to Indigenous practices in Central America and battlefield medicine during the American Civil War. The treatment faded after penicillin arrived in the 1940s, but chronic wounds, drug-resistant infections and patients who cannot easily undergo surgery have kept the idea alive.

The process is controlled, clinical, and far removed from accidental infestation. Health care workers place sterile larvae on a wound, either loose under a dressing or sealed inside a special pouch. The larvae release enzymes that dissolve dead tissue. They then consume the liquefied material, while sparing living tissue.

The larvae used in this treatment differ sharply from parasitic species such as the New World screwworm, whose larvae eat living flesh. The two fly species used in maggot therapy mainly feed on carrion.

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The evidence remains mixed. Small studies suggest maggot therapy can clean dead tissue faster than some conventional methods. A recent systematic review found stronger support for debridement than for overall wound healing. In other words, maggots may clean the wound efficiently, but researchers still need stronger data to prove they improve final healing outcomes.

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What the Clearance Changes

Cuprina Holdings, the Singapore-based company behind MEDIFLY Maggots, says the new clearance gives clinicians another option in a niche field.

“Maggot debridement therapy has earned its place in modern wound care, and adding a second FDA-cleared species strengthens the entire field,” Dr. Ronald Sherman, Cuprina’s medical and scientific director, said in a company press release.

Cuprina says it now holds FDA clearance for both maggot species used in the treatment. The company sees L. sericata as more familiar in Western wound care, while L. cuprina has greater recognition in Australia, Africa, Asia, and parts of the Americas.

“Having a discussion about maggots almost seems ridiculous juxtaposed to modern treatments,” Dr. David Armstrong, a professor of surgery at the Keck School of Medicine, told the Wound Care Education Institute. But the therapy can sometimes “eliminate the need for surgical debridement.”

That does not mean maggots will become routine in hospitals. The treatment carries an obvious image problem, and many clinicians still reserve it for hard-to-treat wounds or patients who have few good alternatives.

For now, maggot therapy remains a specialized option, not a standard first step. The new clearance gives wound-care teams another regulated product to consider for chronic wounds that resist simpler treatments.