The medical leech: An old treatment revisited

@article{Wells1993TheML,
  title={The medical leech: An old treatment revisited},
  author={Mark D. Wells and Ralph T. Manktelow and J. Brian Boyd and Vaughan Bowen},
  journal={Microsurgery},
  year={1993},
  volume={14}
}
The treatment modality of choice for venous insufficiency after free tissue transfer or replantation remains surgical repair. When this is not technically possible, the use of medical leeches is a useful adjunct to treatment. This paper reviews the history of the use of leeches in medicine, the anatomy and physiology of Hirudo medicinalis, the techniques of leech therapy, and the complications and contraindications. © 1993 Wiley‐Liss Inc. 
View on Wiley
ncbi.nlm.nih.gov
82 Citations
Highly Influential Citations
2
Background Citations
15

82 Citations

Citation Type

Citation Type

Leech therapy in digital replantation.
Medicinal leeches for the treatment of venous congestion and hematoma after plastic reconstructive surgery
TLDR
The use of medicinal leeches became rather popular again in recent years, e.
A Comprehensive Review of Medicinal Leeches in Plastic and Reconstructive Surgery
TLDR
The purpose of this article is to provide a platform for understanding the recent literature as it relates to reconstruction to improve understanding of indications and necessary considerations in using hirudotherapy.
By what mechanism do leeches help to salvage ischaemic tissues? A review.
Successful treatment of venous congestion in free skin flaps using medical leeches
TLDR
The results from this small number of patients with free skin tissue transfers are encouraging, suggesting that in the presence of venous congestion, the use of medicinal leeches is a desirable modality of treatment.
Medicinal Leech Therapy: Friend or Foe
  • Marcia E. Spear
  • Medicine
    Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses
  • 2016
TLDR
The history of this ancient therapy is discussed, the leech and its present indications, complications, contraindications, and techniques are described.
Cutaneous complications of improper leech application.
TLDR
Infection is considered the most common complication of hirudotherapy, even though bacteriological examination of leech applied by the patient showed neither bacterial nor parasitic infection.
The efficacy of medicinal leeches in plastic and reconstructive surgery: A systematic review of 277 reported clinical cases
TLDR
A synthesis of current best evidence guides clinicians during the process of consenting patients and using leeches in their practice in the absence of robust randomized controlled trials on which the evidence may be based.
Leech therapy in the management of acute venous congestion of an infant's lower limb.
TLDR
The successful use of leech therapy in the postsurgical management of an infant with acute venous congestion of an entire lower limb and mild cutaneous hyperpigmentation was the only long-term complication.
A novel technique: Subatmospheric pressure wound therapy for treating venous congestion of replanted digits
...
...

References

SHOWING 1-10 OF 19 REFERENCES
CE Feature: Medicinal Leech Therapy: An Overview
TLDR
Leech therapy has made a comeback as a legitimate form of therapy for treating venous congestion following grafts and replants and can be revascularization of replanted tissue.
The salvage of congested skin flaps by the application of leeches.
AV anastomosis as a solution for absent venous drainage in replantation surgery.
TLDR
A method for obtaining venous outflow is described by using the contralateral artery as a venous pole and anastomosing it to a vein in the proximal stump (with or withoutA venous graft).
Salvage of a Failing Microvascular Free Muscle Flap by Direct Continuous Intravascular Infusion of Heparin: A Case Report
TLDR
A free gracilis muscle transfer with skin graft was performed for reconstruction of a type IIIB lower extremity traumatic wound with acute exposure of the distal tibia fracture site and an extensive soft-tissue wound and ultimate full flap survival and wound healing ensued.
Partial nail plate removal after digital replantation as an alternative method of venous drainage.
The emergency management of a medicinal leech bite.
  • S. Adams
  • Medicine
    Annals of emergency medicine
  • 1989
Successful transfer of “free” microvascular superficial temporal artery flap with no obvious venous drainage and use of leeches for reducing venous congestion: Case report
  • C. Lim
  • Medicine
    Microsurgery
  • 1986
A case is presented of “free” flap based on the frontal branch of the left superficial temporal artery and its surrounding soft tissues, without any proper vein for anastomosis, successfully…
The medicinal leech. A page from the annelids of internal medicine.
  • S. Adams
  • Medicine
    Annals of internal medicine
  • 1988
TLDR
The leech lost its hold on the practice of medicine in the early 20th century but recently the use of leeches has resurged in both the lay and the scientific communities.
Hospital-associated infection from leeches.
TLDR
A 3 year old patient's right ear was bitten off by her family dog, leaving only the lobule in place, and several vessels 0.2-0.5 mm in diameter were identified in the ear during the operating room.
Aeromonas hydrophila Infections Following Use of Medicinal Leeches in Replantation and Flap Surgery
TLDR
It is recommended that leech applications be restricted to tissue with arterial perfusion to minimize contamination of necrotic tissue and that patients treated with leeches receive antibiotics effective against Aeromonas hydrophila before leech application.
...
...