2018
DOI: 10.1002/micr.30298
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Experience with pharmacologic leeching with bivalirudin for adjunct treatment of venous congestion of head and neck reconstructive flaps

Abstract: Bivalirudin is a safe and feasible adjunct therapy for treatment of flap congestion. It may serve as a useful alternative to traditional leech therapy, as bivalirudin negates the need for antibiotic prophylaxis, eliminates the psychological aversion associated with leech therapy, and avoids the potential for leech migration. Further work to determine the efficacy of bivalirudin to standard leech therapy is warranted.

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Cited by 10 publications
(7 citation statements)
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References 30 publications
(75 reference statements)
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“…In this case, the anti‐inflammatory effects on the tissue from the leech saliva may have contributed to resolution of UAO. Compounds derived from hirudin have also been found to reduce postoperative venous congestion in humans, which could have contributed to the resolution of UAO in this case 19 . However, there is a lack of controlled trials with hirudotherapy in medical literature 20 …”
Section: Discussionmentioning
confidence: 86%
“…In this case, the anti‐inflammatory effects on the tissue from the leech saliva may have contributed to resolution of UAO. Compounds derived from hirudin have also been found to reduce postoperative venous congestion in humans, which could have contributed to the resolution of UAO in this case 19 . However, there is a lack of controlled trials with hirudotherapy in medical literature 20 …”
Section: Discussionmentioning
confidence: 86%
“…The coronary flow improvement by bivalirudin may be due to additive vasodilatory property or action on the thrombus. Aisha Harun et al study [13] reveals that bivalirudin also has the same effect of leeching treatment with experience with pharmacologic leeching with bivalirudin for adjunct treatment of venous congestion of head and neck reconstructive flaps. Probably bivalirudin was also showing the vasodilatation as superadded effect along with antithrombotic function.…”
Section: Discussionmentioning
confidence: 88%
“…Additionally, leech saliva possesses anticoagulative and platelet inhibition properties ( 9 , 20 , 21 ). Bivalirudin, commonly used as a second line systemic anticoagulant, is a recombinant form of the leech enzyme hirudin ( 22 ). This lends biologic plausibility for its use in local malperfusion due to arterial insufficiency in pediatric patients when standard therapy fails.…”
Section: Introductionmentioning
confidence: 99%