Lyophilized Extract from the Larvae of the Blowfly Lucilia sericata as a New Strategy for the Management of Chronic Wounds

<b>Background/Objectives</b>: Chronic wounds represent a growing challenge for the aging population, significantly impairing their quality of life, increasing the frequency of medical consultations, and imposing substantial healthcare costs. Chronic wounds are prone to complications, including local and systemic infections, and in severe cases, amputations. The therapeutic use of live larvae from the blowfly <i>Lucilia sericata</i> (biological debridement) has regained attention for its ability to debride necrotic tissue and stimulate granulation. Despite its benefits, this therapy is constrained by the logistical challenges of producing and delivering live larvae and by patient adherence issues. <b>Objectives</b>: This study aimed to develop a lyophilized extract of <i>Lucilia sericata</i> larvae and evaluate its efficacy in treating chronic wounds. <b>Methods</b>: A lyophilized maggot extract (Larveel^®, Alpha-Biocare GmbH, Neuss, Germany) of the larvae of <i>Lucilia sericata</i> was produced under GMP conditions. In a total of ten patients with chronic refractory wounds, the extract was used in individual therapeutic trials and its effect on bacterial colonization and wound healing was investigated. Wound healing was documented photographically and measured visually in terms of a reduction in the wound slough, an increase in the granulation tissue, and a reduction in the wound area. <b>Results</b>: Of the ten patients, three discontinued their treatment due to <i>P. aeruginosa</i> colonization. In seven patients, significant fibrin reduction, granulation, and wound healing occurred, with two achieving complete closure and four showing advanced epithelialization. <b>Conclusions</b>: In 7 of the 10 patients, the application of the extract led to a marked reduction in wound slough, and improved granulation and the progression of wound healing. These effects are likely attributable to the extract's ability to disrupt bacterial biofilm formation. The findings suggest that this novel therapeutic approach may provide a practical and effective alternative to live larval therapy for managing chronic wounds.