When people suffer from extensive wounds that just won’t heal, doctors typically use scalpels and enzymes to clean the wound, in a process called debridement. The purpose of debridement is to remove the dead tissue and infected skin, but according to a new study, these methods don’t always work.

Their presence appears to stimulate wound healing as well as offer an antibacterial effect to infected skin.

Enter the maggots. These little critters have been used throughout history to help heal wounds; in 2004, the FDA approved “medical maggot” therapy. Maggots, which are fly larvae, secrete compounds that break up the offending tissue, after which they ingest the material. Their presence appears to stimulate wound healing as well as offer an antibacterial effect to infected skin.

A new study pitted maggot debridement therapy (MDT) against conventional methods in hospitalized patients who had large skin ulcers called venous ulcers. Doctors placed sterile maggots on the wounds of half of the patients, and on the other half, they cleaned the wounds with scalpels, the conventional therapy.

All of the patients were blindfolded, so they could not tell to what group they had been assigned. The groups did not report any differences in sensation between the different methods.

The benefit after eight days was clear: about 66% of the conventional group had wounds containing slough – dead skin that interferes with wound healing. Only 55% of the group receiving maggot therapy had slough on their wounds. But after 15 days of the respective therapies, there was no difference in the healing process. The time it took to apply the MDT was shorter than conventional therapy, since less nursing is required.

The study authors suggest that MDT could be used early on to speed recovery, but after two or three weeks, the preparation should be changed. MDT could also be used in wounds needing quick debridement, like preparation for skin grafts or for people who have diabetic ulcers.

Future studies will be needed to address whether using more maggots would lead to a better effect and if doing so would be more painful to the patient. Meanwhile, if your doctor pulls out a bag of maggots to treat your skin wound, don’t recoil too quickly – you may want to be blindfolded, but the treatment might just work better than a scalpel.

The study was carried out by researchers at the Centre Hospitalier Universitaire de Caen, France, and published in Archives of Dermatology.