Larval Debridement Therapy Versus Sharp Debridement to Remove Biofilm

Inclusion Criteria: * Veterans over 21 years of age * with chronic lower extremity or diabetic foot ulcers (wound duration over 8 weeks) * who at the clinician's judgment requires wound debridement (25% or more of wound bed covered with non-viable tissue) * wound size 1.5 cm (roughly the size of a quarter) or larger in diameter Exclusion Criteria: * Cognitive impairment that would interfere with patient signing own Informed Consent * Veterans on active anticoagulant therapy with most recent (within last week) PT/INR (international normalized ratio of prothrombin time) \> 3.0, or other significant bleeding risk * Active immune suppression just prior to or during study (on systemic corticosteroids\* within 7 days prior, or chemotherapy for cancer or RA treatment within 4 weeks prior to study, or with diagnosis of HIV/AIDS) - \*Nasal steroid sprays will not be excluded * Active systemic antibiotics is an exclusion * Absent dorsalis pedis pulses and Ankle Brachial Index (ABI) \< 0.5 is an exclusion (indicates critical limb ischemia). * Other possible reasons participants could be removed from this study include: transfers to other non-VA facilities, participant is unable to tolerate tissue sampling even with local anesthesia, and/or inability to comply with scheduled research visits. Furthermore, if the participant has significant wound healing so that sampling is not possible after the initial sampling, they will be removed from the study.