Leeches — the good, the bad and the wiggly

O’Dempsey, Tim

doi:10.1179/2046904712z.00000000074

Cited by 4 publications

(8 citation statements)

References 80 publications

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“… 7 , 53 , 58 , 59 , 60 , 61 , 62 , 63 Furthermore, leeches can be vectors for some viruses, fungi and parasites in animals, 64 , 65 , 66 , 67 but it seems that application of leeches to humans also has infection potential. 68 , 69 However, these complications are rare and the most common adverse effects are itching and bleeding on the application area. These adverse effects can be eliminated by small interventions.…”

Section: Discussionmentioning

confidence: 99%

Medicinal leech therapy—an overall perspective

Sığ

Güney

Güçlü

et al. 2017

Integrative Medicine Research

130

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Complementary medicine methods have a long history, but modern medicine has just recently focused on their possible modes of action. Medicinal leech therapy (MLT) or hirudotherapy, an old technique, has been studied by many researchers for possible effects on various diseases such as inflammatory diseases, osteoarthritis, and after different surgeries. Hirudo medicinalis has widest therapeutic usage among the leeches, but worldwide, many different species were tested and studied. Leeches secrete more than 20 identified bioactive substances such as antistasin, eglins, guamerin, hirudin, saratin, bdellins, complement, and carboxypeptidase inhibitors. They have analgesic, anti-inflammatory, platelet inhibitory, anticoagulant, and thrombin regulatory functions, as well as extracellular matrix degradative and antimicrobial effects, but with further studies, the spectrum of effects may widen. The technique is cheap, effective, easy to apply, and its modes of action have been elucidated for certain diseases. In conclusion, for treatment of some diseases, MLT is not an alternative, but is a complementary and/or integrative choice. MLT is a part of multidisciplinary treatments, and secretes various bioactive substances. These substances vary among species and different species should be evaluated for both treatment capability and their particular secreted molecules. There is huge potential for novel substances and these could be future therapeutics.

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Section: Discussionmentioning

confidence: 99%

Medicinal leech therapy—an overall perspective

Sığ

Güney

Güçlü

et al. 2017

Integrative Medicine Research

130

View full text Add to dashboard Cite

show abstract

“…49,50 Additionally, while most literature concentrates on bacterial septic and cellulitic infections, leeches have in the past been linked to viral infections including HIV and hepatitis B. 34 The authors recognize that this study has significant limitations.…”

Section: Discussionmentioning

confidence: 94%

“…Vasopressor use has been proposed as an etiology for limb ischemia in multiple studies. 15,[31][32][33][34][35] Inotropic alpha-receptor vasoconstrictor effects are more pronounced in digital vascular beds. 29 Vasopressin (arginine-vasopressin) specifically has higher peripheral receptors in the skin, and in one study 68% of vasopressin-mediated ischemia occurred in distal limbs.…”

Section: Discussionmentioning

confidence: 99%

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

Resch

Said

Steiner

et al. 2021

Journal of Cardiac Surgery

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Introduction: Disordered coagulation, clot formation and distal limb ischemia are complications of extracorporeal membrane oxygenation (ECMO) with significant morbidity and mortality. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and orthopedic surgeries to improve venous congestion and salvage ischemic flaps. To our knowledge this has not been reported in pediatric cardiac surgery or during ECMO support. We present a complex neonate whose ECMO course was complicated by distal limb ischemia for whom leech therapy was attempted.Patient and Intervention: A 2-week-old 2.7 kg infant required ECMO support secondary to perioperative multiorgan system dysfunction following repair of critical coarctation and ventricular septal defect. Despite systemic anticoagulation, his clinical course was complicated by arterial thrombus, vasopressor-induced vascular spasm and bilateral distal limb ischemia. Medicinal leech therapy was tried after initially failing conventional measures.Result: Following the third leech application, this patient developed significant hemorrhage from the web space adjacent to the left great toe. An estimated 450 ml of blood loss occurred and more than 300 ml of blood product transfusions were required. He ultimately progressed to irreversible systemic end organ dysfunction and comfort care was provided. Conclusion:The use of medicinal leech therapy in pediatric cardiac surgery may be considered to minimize the consequences of advanced limb ischemia and venous congestion. However, this should be used with caution while patients are systemically anticoagulated during ECMO support. A directed review is presented here to assist in determining optimal application and potential course of therapy.

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“…Leech therapy was first approved by the Food and Drug Administration for graft tissue healing in 2004, and since then, the use of leech therapy is expanding into alternative methods of treatments of joint pain including knee pain from osteoarthritis [1,[7][8][9]. Leeches have over 100 bioactive substances that work synergistically.…”

Section: Discussionmentioning

confidence: 99%

“…Hirudotherapy, the use of leeches in medical treatment, began as early as 200-130 BC [1]. Initially it was used for bloodletting and 'balancing the biological humors' [2].…”

Section: Introductionmentioning

confidence: 99%

Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy

Curcio¹,

Lloyd²

2020

Cureus

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A 58-year-old male presented to the emergency department with a chief complaint of knee pain and swelling after performing hirudotherapy (leech therapy) approximately one week prior. Knee arthrocentesis demonstrated significant hemarthrosis. Hirudotherapy is being used for a broad array of reasons including treatment of osteoarthritis, to plastic and reconstructive surgery. Case reports and journal articles often discuss cutaneous reactions, bleeding, and infection as common adverse events. Intra-articular bleeding is not commonly mentioned. With hirudotherapy being utilized more as alternative therapy for osteoarthritis and joint pain, physicians should be aware of hemarthrosis as a possible adverse reaction.

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Leeches — the good, the bad and the wiggly

Cited by 4 publications

References 80 publications

Medicinal leech therapy—an overall perspective

Medicinal leech therapy—an overall perspective

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

Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy

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