Evaluation of leech therapy in flap venous congestion

Abstract

Background: One of the common problems in flap surgery is venous congestion. The literature contains a plethora of alternative procedures to surgical revision for dealing with this issue. The leech therapy is one of these procedures. In the present study, leech therapy was used for the treatment of twenty cases with venous congested flaps. The technique, results and complications will be presented and discussed. Objective: The aim of this study is to spotlight on the efficacy of leech therapy in salvage of venous congested flaps. Patients and Methods: A prospective clinical study was carried out on 20 patients with post-operative venous congested fascio-cutaneous flaps. These patients were treated by leech therapy at Al-Zahraa University Hospital and Al-Mataria Teaching Hospital during the period between May 2020 and April 2021. Results: The percentage of congested areas in the flaps before leech therapy was ranged between 10% and 100%. The final outcomes of these congested flaps after leech therapy were dramatic regarding improvement in venous congestion and subsequently flap survival. The flap survival rate was ranged between 60% and 100% with a mean of 88.25%. Conclusion:The use of leech therapy has proved its efficacy in significantly relieving flap venous congestion and subsequently increases flap survival rate. Leech therapy should be started as early as possible after other means of venous outflow establishment are exhausted. Guidelines should be strictly fulfilled to avoid biohazards of leech therapy.