Hirudotherapy in Wound Healing

Abstract

Leeches are hermaphrodite, bloodsucking parasitic worms usually found in places with fresh water. Leech therapy existed 3000 years, and it is being used at a different scope. Several species of leeches have been used in medicine, and the most common species used is Hirudo medicinalis. Leeches suck the excess blood, reduce the swelling in the tissues, and promote healing by allowing fresh oxygenated blood to reach the area until normal circulation can be restored. Pain relief from leech therapy is rapid, effective, and long-lasting in many conditions. The aim of this study was to evaluate the efficacy and duration of healing utilizing sterile medicinal leeches, Hirudinaria manillensis, in the management of pain and wound healing. Leech was taken out from its sterile tube by using a pair of non-tooth sterile plastic forceps and gloved hands. Each leech was left in place for as long as it was feeding. Leeches were removed only after they became detached from the patient. The specimen jars containing the used leeches were sealed in either a biohazard bag or in a small yellow clinical waste bin liner securely fastened with a cable tie. The leech was killed by using 70% alcohol prior to disposal into a yellow hazard bin, which undergoes incineration. All 3 patients had improvements in their condition, especially in terms of reduction in the pain and improvement in their sense of balance. All the wounds healed well. Therefore, leech therapy is effective in reducing pain and increasing perfusion to allow the wounds to heal quickly. However, a more robust trial is needed to show significance as the sample size is small.

The Role of the Extracellular Matrix (ECM) in Wound Healing: A Review

“…The secreted collagen is disorganized, lacks structural integrity, and the resulting scar tissue never achieves the tensile strength of native skin [ 17 ]. Current methods to treat intractable wounds that involve second intention healing include the use of antibacterial, debridement, irrigation, vacuum-assisted closure, oxygenation, moist wound healing, hirudotherapy, and collagen-based dressings/fillers [ 18 , 19 , 20 , 21 , 22 ].…”

Hirudotherapy for neonatal limb ischemia during ECMO support: A word of caution

“…A leech is applied typically to the clinical zone of maximal ischemia and re‐applied every 4 h following detachment if clinically tolerating. Leeches tend to disengage from the target organism when satiated with blood, which is typically after 15–45 min, though maximally reported as 2 h 30 . The literature does not provide guidance as to methods of leech application per area of ischemia to our knowledge.…”

“…A leech is applied typically to F I G U R E 1 Vasopressor peak daily dosing the clinical zone of maximal ischemia and re-applied every 4 h following detachment if clinically tolerating. Leeches tend to disengage from the target organism when satiated with blood, which is typically after 15-45 min, though maximally reported as 2 h. 30 The literature does not provide guidance as to methods of leech application per area of ischemia to our knowledge. Our institution uses a multidisciplinary approach on a case-by-case basis and leech reapplication tends to be empirical based on achieved response.…”

Medicinal leech in the blood bank laboratory plumbing

“…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. Proper disposal of used leeches is described in medical publications 2 …”