Bio Surgery (Larval Therapy)

Bio Surgery – Larval Therapy

Why is this type of therapy being used?

The qualified nurses and your medical team feel that this therapy will be ideal for your wound / ulcer to progress, and will help lift any bad tissue present. Qualified nurses and doctors have used this therapy for many years, and have found it to be very effective because it allows the healing process to begin.

How does maggot therapy work?

In simple terms, maggots release an enzyme onto the wound, which breaks down the dead tissue into a liquid form, which the maggots can easily remove and digest. Maggots also remove any bacteria (germs).

How big are the maggots?

When the maggots are applied to your wound, they are very small, only a few millimetres in length, which is smaller than a grain of rice. They do increase in size during the time they are on your wound, as this indicates they are having the desired effect, which is to remove the dead and/or infected tissue.

How is this therapy applied?

The qualified nurse will get permission from your Consultant or General Practitioner prior to applying this therapy. To keep the maggots within the wound, a special dressing system is applied. An adhesive dressing is applied to the surrounding wound edges for protection. The maggots are then placed in the wound and covered with a fine mesh dressing, which is fixed securely with tape. A slightly moist absorbent pad is then applied and secured with a bandage.

For deep wounds to the leg or foot, the maggots are covered with a nylon net boot.

The absorbent dressing is changed twice daily, as the maggots need salt water to prevent them from drying up.

How long does the treatment last?

Usually maggots are left in place for three days. Further treatments may be required, but most wounds are cleansed after one application.

Will the maggots be painful? Will I notice anything during the treatment?

Most people are unaware of the maggots' presence. However, some people claim that they can feel the maggots moving, but describe this as a tickling sensation.

Patients with poor circulation have reported their wound to be more painful, but this can be controlled with medication.

You may be able to smell your wound. This is due to the activity of the maggots and should disappear when the outer dressing is changed

Some patients notice an increase in exudate (weeping), or that the wound has dark red or pink discharge. This is normal and is due to the action of the maggots breaking down the dead tissue.

What happens if I refuse?

You have the choice of taking this treatment. If you refuse this treatment you will be treated with more traditional dressings to treat your wound.


Prior to application we will require your consent, as well as the consent of the Consultant or General Practitioner whose care you are under.


The use of this therapy offers quick removal of slough and necrotic (dead) tissue from your wound/ulcer, thereby encouraging granulation (healthy) tissue to form, aiding healing. No significant risks or adverse events have been linked to the use of larvae.


You may need more than one treatment. If your ulcer is in a difficult location such as your heel, you may be advised to have bed rest whilst the larvae are applied to prevent crushing them.