A Comprehensive Review of Medicinal Leeches in Plastic and Reconstructive Surgery

Hackenberger, Paige N; Janis, Jeffrey E.

doi:10.1097/gox.0000000000002555

Cited by 20 publications

(25 citation statements)

References 39 publications

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“…Although these findings are promising, hirudotherapy can have serious complications with an overall rate of 21.8% [ 14 ]. The most common complications are infection and prolonged bleeding.…”

Section: Discussionmentioning

confidence: 99%

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Improving Symptoms of Peripheral Artery Disease With Hirudotherapy

Afify¹,

Alkhouri²,

Lauder³

2021

Cureus

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Peripheral artery disease (PAD) is a significant cause of morbidity and mortality in the world. Critical limb ischemia is a complication of PAD that leads to severe pain at rest, numbness, and absent or diminished pulses in the legs or feet. Revascularization with surgery or endovascular intervention is required to reestablish blood flow to the affected areas. Failure to respond to medical and/or surgical treatment can lead to amputations. The decision to amputate one's limb can be very challenging. Here, we report a patient with critical limb ischemia who refused a below-the-knee amputation and self-treated with medicinal leech therapy, or hirudotherapy. His symptoms including his pain, burning, and numbness improved significantly following six months of therapy.

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Section: Discussionmentioning

confidence: 99%

“…Leeches serve as vectors for the Aeromonas species of bacteria, which can manifest in a variety of ways, most commonly as a gastrointestinal infection. Because of this risk, antibiotic prophylaxis is recommended when using leeches [ 14 ]. Furthermore, excessive bleeding from leech therapy can lead to significant anemia.…”

Section: Discussionmentioning

confidence: 99%

Improving Symptoms of Peripheral Artery Disease With Hirudotherapy

Afify¹,

Alkhouri²,

Lauder³

2021

Cureus

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“…Medicinal leeches are used to reduce redness, swelling, and pain at sites of injury or inflammation. Their ability to reduce venous congestion in skin flaps under tension following plastic and reconstructive surgery was documented in the 1980s, and they were approved as medical devices by the US Food and Drug Administration in 2004 1 …”

Section: Figurementioning

confidence: 99%

“…Their ability to reduce venous congestion in skin flaps under tension following plastic and reconstructive surgery was documented in the 1980s, and they were approved as medical devices by the US Food and Drug Administration in 2004. 1 Our hospital uses leeches extensively in trauma, burn, and necrotizing fasciitis reconstructive surgery and raises them in a tank in the pharmacy a floor above the blood bank. Neither the pharmacy nor the using surgical teams admit to the recent loss of a leech or improper disposal of this potentially hazardous biologic known to transmit bacterial infections with its bite and potentially contaminated with human blood.…”

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confidence: 99%

Medicinal leech in the blood bank laboratory plumbing

2021

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“…Infections can occur 1 to 30 days after the application of leeches and are associated with a dramatic decrease in ap salvage rates (from 88% to 37%) (5,6). Prophylactic treatment with antibiotics (such as third generation cephalosporins, gentamicin, uoroquinolones and/ or cotrimoxazole) is therefore indicated during hirudotherapy (7).…”

mentioning

confidence: 99%

The Risk-Benefit Ratio of Leech Therapy: A Single-Center Retrospective Study

Fillatre

Floug

Assaf

et al. 2021

Preprint

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Background: Venous congestion in transplanted or replanted tissues remains a common and challenging complication of plastic and reconstructive surgery. The local application of medicinal leeches is effective in reducing postoperative venous congestion in skin flaps and restoring normal blood flow. However, leech therapy is associated with a number of risks, including infections; in order to digest blood, leeches have a symbiotic relationship with Aeromonas species in their gut. Aeromonas infections are associated with a dramatic decrease in flap salvage rates. This is why prophylactic antibiotic treatment and external decontamination of the leeches are widely recommended. Methods: We performed a single retrospective study of patients having undergone leech therapy between January 1st, 2010, and December 31st, 2018, at Amiens-Picardie University Hospital, France. Each patient’s medical history, clinical data, laboratory results, prophylactic antibiotic use, and complications were recorded.Results: A total of 37 patients (mean age: 47) had undergone leech therapy after reconstructive surgery. Antimicrobial prophylaxis was documented in 32 (84.6%) patients. However, there are no guidelines on the choice of prophylactic antibiotic treatment. Twenty-four of the 37 (64.8 %) patients had anemia (mean hemoglobin level: 8.5 (6-11.1) g/dL), and 13 of the 24 (54%) required a transfusion. Thirteen of the 37 patients (35.1%) had a post-operative infection mainly due to Aeromonas spp. (76.9%). Leech therapy was effective in 23 of the 37 patients (62%) overall and in 2 of the 10 patients (20%) with an Aeromonas infection. The association between Aeromonas infection and flap salvage failure was highly significant (p = 0.005).Conclusions: The results of the study emphasized that clinical bacteriologists and surgeons should be aware that leeches are potential sources of infection.

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A Comprehensive Review of Medicinal Leeches in Plastic and Reconstructive Surgery

Cited by 20 publications

References 39 publications

Improving Symptoms of Peripheral Artery Disease With Hirudotherapy

Improving Symptoms of Peripheral Artery Disease With Hirudotherapy

Medicinal leech in the blood bank laboratory plumbing

The Risk-Benefit Ratio of Leech Therapy: A Single-Center Retrospective Study

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