“As the last few inches [of bandage] peeled stickily away some maggots dropped to the floor and Sergeant Harper knelt to pick them up… Sharpe… picked off a last fat maggot and gave it to Harper… A handful of maggots did more than any army doctor, eating away the diseased tissue to let the healthy flesh close naturally… ‘Thank you, Sergeant. Good as new.’” (Cornwall, 1981)
The books about Captain Richard Sharpe during the Napoleonic Wars of the early nineteenth century are fiction. The use of maggots to help wounds to heal is not. Prior to the discovery of antibiotics, infection in wounds often led to sepsis and eventual death. Prior to the availability of penicillin in the 1940s, physicians were often unable to save soldiers wounded in battle because they had no effective cure.
There was one: maggots.
A photo of some maggots in a wound is on the right. You may never have seen a maggot. Maggots are fly larvae. When an animal dies in the forest, other animals come to eat. Flies lay eggs in the dead tissue. The eggs hatch into larvae who eat the dead tissue. Finding a dead animal with a body cavity filled with maggots is really gross. It takes a leap of faith to share Captain Sharp’s gratitude towards maggots.
Maggots, for some reason, do not eat living flesh and that is their value in wound healing. Maggots seem to have been used for healing since… well, no one knows since when, but at least for a long time.
“The first documented therapeutic use of maggots in the United States is credited to a Confederate medical officer Dr. J.F. Zacharias, who reported during the American Civil War that: ‘Maggots in a single day would clean a wound much better than any agents we had at our command … I am sure I saved many lives by their use.’” (Wikipedia; Donnelly, 1998)
“In 1928, William Baer, an orthopedic surgeon, is credited with the first use of blowfly maggots to treat osteomyelitis wounds in hospital. Maggots were used extensively in hospitals during the 1930s and 1940s, especially in the United States. After the invention of penicillin and better surgical techniques, the interest in maggot debridement therapy (MDT) gradually disappeared in the early 1940s until 1980s when methicillin-resistant Staphylococcus aureus (MRSA) became a problem… With the appearance of antibiotic resistance and increasing problems in treating chronic wounds worldwide, MDT re-emerged as a useful therapy for surgical wounds infected with antibiotic-resistant S. aureus.” (Choudhary, 2016)
Specially bred maggots are available in sterile packaging for clinical use. Current maggot debridement therapy (MDT) uses live, disinfected maggots (fly larvae) which are placed in a non-healing wound to eat the necrotic tissue and disinfect the wound. Research into current effectiveness is limited. “The quality of research into MDT has been insufficient to establish its efficacy. In a Cochrane meta-analysis, the overall evidence for its use was considered low. Nevertheless, a clear and consistent pattern in all the studies suggests that the maggots increased the speed of wound debridement in the first week of treatment compared to hydrogel therapy. In addition, maggots have been shown to produce anti-microbial peptides, which have broad-spectrum bactericidal activity.” (Zubir, 2020)
The use of maggots is not without some risks. In some fly species, the maggots can invade the skin and subcutaneous tissues, and cause painful lesions. See Sunny, 2018.
Resources
- Sharp’s Eagle, Bernard Cornwell, Penguin, 1981. Maggots in fiction, Fandom.
- The Maggots: Professional Wound Cleaners, Michael A.B. Naafs, Infection control.tips, October 2027.
- Maggot therapy, Wikipedia.
- Penicillin, Wikipedia.
- New Science Shows How Maggots Heal Wounds, Carry Arnold, Scientific American, April 2013.
- Maggots in medicine: Ancient therapy making comeback as wound-healing option, Mitch Mirkin, US Department of Veterans Affairs, August, 2025.
- Wound healing–from poultices to maggots (a short synopsis of wound healing throughout the ages), Jean Donnelly, The Ulster Medical Journal, 1998.
- Maggot Therapy in Wound Healing: A Systematic Review, Mohd Zubir et al., Int J Environ Res Public Health, August 2020.
- Maggot debridement therapy as primary tool to treat chronic wound of animals, Vijayata Choudhary et al., Vet World, April 2016.
- Maggot Infestation: Various Treatment Modalities, Basil Sunny et al., J Am Coll Clin Wound Spec, March 2018.
- Image from: Maggot Therapy: The Science and Implication for CAM Part I-History and Bacterial Resistance, Nigam Y et al., Evidence-based complementary and alternative medicine.
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