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Bates A. From bloodthirsty parasites to surgical superstars: The humble leech, a suck-cess story in surgical history. J Perioper Pract 2024:17504589241237363. [PMID: 38606918 DOI: 10.1177/17504589241237363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This historical review delves into the extensive and intriguing history of leeches in surgery. The utilisation of leeches in medical practice dates back thousands of years, from ancient civilisations to the modern era. The therapeutic properties of leeches have led to their persistent presence in surgical procedures. The 'Age of Leeches' during the 18th and 19th centuries witnessed a heightened utilisation of leeches in surgical treatment, given their perceived ability to promote postoperative wound healing and alleviate blood congestion. However, advancements in medical knowledge subsequently diminished their popularity as emerging technologies overshadowed them. Nevertheless, recent years have witnessed a resurgence in the use of leeches in reconstructive surgery, driven by both a greater understanding of their biological mechanisms and their potential source of therapeutic agents. This historical review provides a comprehensive exploration of the historical timeline, societal perceptions and scientific advancements surrounding the use of leeches in surgical practice.
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Sher C, Dreznik Y, Yekutiel G, Berant R, Kravarusic D. Umbilical Incarcerated Hernia With Omental Eventration Caused by a Leech Bite in a Pediatric Patient. Cureus 2023; 15:e44831. [PMID: 37809215 PMCID: PMC10559647 DOI: 10.7759/cureus.44831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Medicinal leech therapy (MLT) is used in various medical disciplines, among which are reconstructive surgery and microsurgery. Medicinal leech therapy is also often adopted by alternative and traditional medicine, aiming to treat various common medical symptoms, such as fever and arthritis. Congenital umbilical hernia is a rather common physical finding in the pediatric population, where every third Caucasian newborn, roughly, is being diagnosed with the condition, and even more so among the African population. Fortunately, most cases resolve spontaneously in the first years of life. Toddlers whose hernia does not close typically require umbilical hernia repair. This article describes the case of a five-year-old girl with an asymptomatic congenital umbilical hernia who was admitted to the ER due to an omental eventration that occurred following the placement of a leech on her umbilicus in her parents' attempt to treat a febrile episode. She subsequently underwent an urgent umbilical exploration and a repair of her umbilical hernia. The main known risks of leeching are bacterial infection, anemia, prolonged bleeding, and, less frequently, pruritus, allergies, marked edema, and cellulitis. This article presents yet another possible complication that, to the best of our knowledge, has not been documented before in the literature. Several old-school therapies transcended over time into medical disciplines. Given that "traditional" practices often take place within households and communities, it is of crucial importance to point out potential complications, both rare and common, that can be caused by those practices in order to reduce the risk of severe, undesired outcomes. Indeed, the growing interface between traditional, alternative therapies and modern, conventional medicine urges better parental guidance and improved education regarding potentially harmful and unauthorized interventions.
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Affiliation(s)
- Carmel Sher
- Department of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petah Tiqwa, ISR
- Faculty of Medicine, Tel Aviv University, Tel Aviv, ISR
| | - Yael Dreznik
- Department of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petah Tiqwa, ISR
- Faculty of Medicine, Tel Aviv University, Tel Aviv, ISR
| | - Gal Yekutiel
- Department of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petah Tiqwa, ISR
- Faculty of Medicine, Tel Aviv University, Tel Aviv, ISR
| | - Ron Berant
- Department of Emergency Medicine, Schneider Children's Medical Center of Israel, Petah Tiqwa, ISR
- Faculty of Medicine, Tel Aviv University, Tel Aviv, ISR
| | - Dragan Kravarusic
- Department of Pediatric and Adolescent Surgery, Schneider Children's Medical Center of Israel, Petah Tiqwa, ISR
- Faculty of Medicine, Tel Aviv University, Tel Aviv, ISR
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Özkaya D. Keratitis following leech therapy for periocular eczematous dermatitis: a case report. BMC Complement Med Ther 2023; 23:124. [PMID: 36588163 PMCID: PMC9806876 DOI: 10.1186/s12906-022-03613-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/29/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The medicinal leech therapy (MLT) is a kind of complementary treatment method used for various diseases. The leeches (Hirudo medicinalis) have been used for more than 2500 years by surgeons. The substances presenting in the saliva of leeches have anti-inflammatory, anticoagulant, platelet inhibitory, thrombin regulatory, analgesic, extracellular matrix degradative and antimicrobial effects. The method is cheap, easy to apply, effective and its mechanisms of action have been clarified for specific diseases. Infection particularly Aeromonas infection is the most common complication of MLT. CASE PRESENTATION In this case report, a keratitis case developing after leech therapy applied for the periocular and facial eczematous dermatitis lesions will be presented. The patient referred to our hospital with decreased vision, ocular pain, stinging, redness and lacrimation complaints. A large corneal epithelial defect with irregular margins, dying by fluorescein, involving more than inferior half of cornea and conjunctival hyperemia were seen in the right eye. No agent was determined in microbiological investigation, as the patient had used topical moxifloxacin eye drop which was commenced in another clinic before applying to us. The patient was treated with fortified vancomycin and ceftazidime, before using besifloxacin with the diagnosis of bacterial keratitis. Three weeks later epithelial defect improved completely leaving an opacity and neovascularization. CONCLUSIONS MLT should be performed by certified physicians with sterile medicinal leeches and precautious antibiotics should be used before MLT for prevention against potential infections.
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Affiliation(s)
- Dilek Özkaya
- grid.45978.37Department of Ophthalmology, Süleyman Demirel University Faculty of Medicine, 32260 Isparta, Turkey
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Case Reports and Experts Opinions about Current Use of Leech Therapy in Dermatology and Cosmetology. COSMETICS 2022. [DOI: 10.3390/cosmetics9060137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This article aimed to determine the experts’ opinion on the use of hirudotherapy in cosmetology, to supplement knowledge, and to identify factors that, in the opinion of experts, affect the effectiveness and frequency of use of this method in eliminating skin problems. The study was conducted using the expert interview method. The research tool was a categorized expert interview questionnaire using the CAWI (Computer Assisted Web Interview) technique. Hirudotherapy is one of the oldest healing methods. The mechanism of action is based on the therapeutic properties of bioactive substances isolated from leech saliva. It has been shown to have a wide range of applications in the treatment of numerous diseases in various fields of medicine, including dermatology and cosmetology. Despite its therapeutic properties and effectiveness, hirudotherapy is a rarely used tool in cosmetology. It has been found effective in the treatment of many dermatoses. The most spectacular effects have been observed in the treatment of rosacea, local inflammations, lipomas, skin scars, hard to heal wounds and contusions.
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Huang Q, Tang J, Chai X, Ren W, Wang J, Gan Q, Shi J, Wang M, Yang S, Liu J, Ma L. Affinity ultrafiltration and UPLC-HR-Orbitrap-MS based screening of thrombin-targeted small molecules with anticoagulation activity from Poecilobdella manillensis. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1178:122822. [PMID: 34147951 DOI: 10.1016/j.jchromb.2021.122822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 01/19/2023]
Abstract
This study aims to screen potential anticoagulant components from leeches, a representative animal-sourced traditional Chinese medicine using thrombin (THR)-targeted ultrafiltration combined with ultrahigh performance liquid chromatography and high-resolution Orbitrap mass spectrometry (UPLC-HR-Orbitrap-MS). As a result, five small molecules in leech extract were discovered to interact with THR for the first time. Among them, two new compounds were isolated and their structures were identified by IR, HR-MS and NMR data. Furthermore, their THR inhibitory activity was confirmed with IC50 values of 4.74 and 8.31 μM, respectively. In addition, molecular docking analysis showed that the active (catalytic) site of THR might be the possible binding site of the two hits. Finally, reverse screening analysis indicated that LTA4-H, ACE and ALOX5AP were potential anticoagulant targets of the two new compounds. This study will broaden our understanding of the medicinal substance basis in leeches and further contribute to the discovery and development of clinical anticoagulant drugs from leeches.
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Affiliation(s)
- Qiuyang Huang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
| | - Jianyuan Tang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China
| | - Xiaoxin Chai
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
| | - Wei Ren
- Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, China
| | - JiaBo Wang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
| | - Qichao Gan
- Chongqing Duoputai Pharmaceutical Co., Ltd, Chongqing 400800, China
| | - Jingyan Shi
- Chongqing Duoputai Pharmaceutical Co., Ltd, Chongqing 400800, China
| | - Manyuan Wang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
| | - Sijin Yang
- Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, China
| | - Jingfang Liu
- Public Technology Service Center, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Li Ma
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China.
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Hernigou P, Hernigou J, Scarlat M. The Dark Age of medieval surgery in France in the first part of Middle Age (500-1000): royal touch, wound suckers, bizarre medieval surgery, monk surgeons, Saint Healers, but foundation of the oldest worldwide still-operating hospital. INTERNATIONAL ORTHOPAEDICS 2021; 45:1633-1644. [PMID: 33394075 DOI: 10.1007/s00264-020-04914-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/11/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE During the Middle Ages, the Christian church established itself as the dominant force over all aspects of medieval life, including the practice of medicine. As the Church's influence expanded across Europe, the role of lay practitioners in medicine declined, and clerics gradually assumed the role of healers in surgical practice as the cure of the soul was felt to take precedence over cure of bodily ills. MATERIAL AND METHODS A retrospective analysis of hospital foundation, old-school surgical techniques still used today was performed during the first part of the Middle Age. RESULTS The Hospital Hotel Dieu in Paris was founded and remains the oldest worldwide still-operating hospital. The monastery became a resting place for travelers, as well as a place of refuge for the sick. As this role expanded, monks often developed considerable surgical expertise. This led to fierce competition for saintly relics and pilgrims. Among the myriad of saints to whom powers of healing were ascribed, the names of Damian and Cosmas figure prominently in medical history. Old-school medieval surgery was also performed with some bizarre techniques such as lip service by wound suckers, cautery, blood-letting, leech therapy, and maggot therapy. CONCLUSION This account of surgery before it became scientific is based on a chronology that runs from the Clovis baptism to the reign of Charlemagne; much of the medicine in this period was based on ancient doctrines; indeed, much of the development of medicine in the period called as "Dark Age" was due to the slow and difficult business of recovering and trying to understand ancient medicine.
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Affiliation(s)
- Philippe Hernigou
- Orthopedic Department Henri Mondor Hospital, University Paris East, Paris, France.
| | - Jacques Hernigou
- Department of Orthopaedic and Traumatology Surgery, EpiCURA Hospital, Baudour/Hornu, Saint-Ghislain, Belgium
| | - Marius Scarlat
- Département Chirurgie Orthopédique, Clinique Chirurgicale St Michel, Groupe ELSAN, Av. Orient, 83100, Toulon, France
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Shakouri A, Wollina U. Time to Change Theory; Medical Leech from a Molecular Medicine Perspective Leech Salivary Proteins Playing a Potential Role in Medicine. Adv Pharm Bull 2020; 11:261-266. [PMID: 33880347 PMCID: PMC8046405 DOI: 10.34172/apb.2021.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 01/13/2023] Open
Abstract
Followed by developing modern medicine, leeches did not have extensive use as before; however, in the late 19th century, they were still used in most countries all over the world. Thus far, leeches were utilized in treating various diseases like skin disorders, arthritis, and cancer. In Egypt, using leeches for treatment dates back to early 1500 BC. A medical leech’s salivary glands involve over 100 bioactive proteins and the salivary gland secretion contains bacteriostatic, analgesic, and anticoagulation influences; with resolving activity, it causes microcirculation disorders elimination, restoring the hurt vascular permeability of organs and tissues, removing hypoxia, decreasing blood pressure and detoxifying the organism by antioxidant paths. The current work reviews the innovative treatment with medical leech, especially proteins in leech saliva extraction (LSE) with high potential in medicine. The virtue of salivary gland secretions which are proteinaceous enzymes, leech acts on various diseases such as venous congestion in reconstructive and plastic surgery, osteoarthritis, cardiovascular diseases caused by blood coagulation disorders, pain management, priapism, macroglossia, cancer complications, wounds and many other. To confirm the potential therapeutic impacts of leech treatment, more studies are required in more extensive areas with more exact methodologies.
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Affiliation(s)
- Amir Shakouri
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
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Curcio J, Lloyd CM. Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy. Cureus 2020; 12:e6915. [PMID: 32190470 PMCID: PMC7061820 DOI: 10.7759/cureus.6915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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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Affiliation(s)
- Janine Curcio
- Emergency Medicine, OhioHealth Doctors Hospital, Columbus, USA
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A Comprehensive Review of Hirudiniasis: From Historic Uses of Leeches to Modern Treatments of Their Bites. Wilderness Environ Med 2017; 28:355-361. [DOI: 10.1016/j.wem.2017.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 08/09/2017] [Accepted: 08/15/2017] [Indexed: 11/22/2022]
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Affiliation(s)
- Francesca L. Ware
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicester LE12 5RD, UK
| | - Martin R. Luck
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicester LE12 5RD, UK
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Jha K, Garg A, Narang R, Das S. Hirudotherapy in Medicine and Dentistry. J Clin Diagn Res 2015; 9:ZE05-7. [PMID: 26817000 PMCID: PMC4717768 DOI: 10.7860/jcdr/2015/16670.6918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 10/26/2015] [Indexed: 11/24/2022]
Abstract
The concept of Unani medicine is based on balancing body humours, the imbalance of which causes diseases. The application of leech therapy in medical and dental science is well recognized. Although easy and non-invasive, complications also exist. The article aims to presents a brief review on the applications of leech therapy. The physiological effect, along with its therapeutic role in cancer, diabetes and dentistry have been underlined. Complications of leech therapy have also been dealt with.
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Affiliation(s)
- Kunal Jha
- Senior Lecturer, Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Aarti Garg
- Senior Lecturer, Department of Pedodontics & Preventive Dentistry, Jaipur Dental College, Rajasthan, India
| | - Ridhi Narang
- Senior Lecturer, Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Sunanda Das
- Assistant Editor, Journal of Clinical and Diagnostic Research, Delhi, India
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13
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TarazJamshidi M, Bagheri F, Mirkazemi M, Amelfarzad S, Ashraf H, Azami M, Peivandi MT. Leech therapy in nearly total amputation of fingers without vascular repair: a case report. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e6897. [PMID: 25031865 PMCID: PMC4082525 DOI: 10.5812/ircmj.6897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/04/2013] [Accepted: 01/26/2014] [Indexed: 11/30/2022]
Abstract
Introduction: In the absence of microvascular replantation or in crash injury cases in which obtaining an acceptable function is not possible, amputation of the injured finger seems to be the best treatment modality. Some studies recommended leech therapy for this kind of injury after vascular repair to decrease venous congestion. Case Presentation: In this case report, the authors presented a case of leech therapy after near total amputation of the fingers. A 25-year-old patient was admitted following a sawing injury with crashed bundles of the third, fourth and fifth fingers. Microvascular surgery was not performed because of crush injury. Discussion: After a simple repair and pin fixation, the patient was treated using leech therapy. The result was satisfactory. The third and fourth fingers were salvaged. It seems that in cases where a small part of the skin is still attached to the amputated part, even with complete crash of both bundles, leech therapy can help salvage the amputated fingers.
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Affiliation(s)
- Mohammad TarazJamshidi
- Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Farshid Bagheri
- Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Masud Mirkazemi
- Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Sara Amelfarzad
- Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hami Ashraf
- Department of Research and Education, Razavi Hospital, Mashhad, IR Iran
| | - Mehran Azami
- Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Mohammad Taghi Peivandi
- Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding Author: Mohammad Taghi Peivandi, Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel/Fax: +98-5118523200, E-mail:
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Ozyurt S, Koca G, Demirel K, Baskın A, Korkmaz M. Findings of bone scintigraphy after leech theraphy. Mol Imaging Radionucl Ther 2014; 23:25-7. [PMID: 24653932 PMCID: PMC3957968 DOI: 10.4274/mirt.303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/25/2012] [Indexed: 12/01/2022] Open
Abstract
In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy) on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy’s dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy. Conflict of interest:None declared.
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Affiliation(s)
- Sinem Ozyurt
- Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey
| | - Gökhan Koca
- Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey
| | - Koray Demirel
- Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey
| | - Aylin Baskın
- Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey
| | - Meliha Korkmaz
- Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey
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Koeppen D, Aurich M, Rampp T. Medicinal leech therapy in pain syndromes: a narrative review. Wien Med Wochenschr 2013; 164:95-102. [PMID: 24081747 DOI: 10.1007/s10354-013-0236-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 08/05/2013] [Indexed: 10/26/2022]
Abstract
Medicinal leech therapy is used in a variety of conditions; most of which have pain as a major symptom. Its mode of action relies on the injection of leech saliva into patients' tissues during the process of blood withdrawal. Leech saliva contains active ingredients with anti-inflammatory, thrombolytic, anti-coagulant and blood- and lymph-circulation enhancing properties. A specific analgesic substance within the leech saliva is yet to be identified. Pain relief from leech therapy is rapid, effective and long-lasting in many conditions. This review compiles studies and case reports that provide clinical evidence for leech therapy's analgesic effects.
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Affiliation(s)
- Detlev Koeppen
- Biebertaler Blutegelzucht GmbH, Talweg 31, 35444, Biebertal, Germany,
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Martin G, Linnell JD, Yang SS, Lin J, Camarata PJ, Andrews BT. Ultrasound localization of a tunneled leech beneath a microvascular scalp reconstruction: A case report. Microsurgery 2013; 33:572-4. [PMID: 23996135 DOI: 10.1002/micr.22163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 06/17/2013] [Accepted: 06/25/2013] [Indexed: 11/09/2022]
Abstract
Medicinal leech therapy is a common adjuvant modality used to treat venous congestion following threatened microvascular anastomosis. Migration and tunneling of a leech beneath a surgical reconstruction is a rare event that is seldom mentioned in the literature and worthy of further discussion. We present a rectus abdominus myocutaneous free tissue transfer that was used to cover a large alloplastic cranioplasty following resection of a previously radiated skull base malignant meningioma. The flap became congested postoperatively and required leech therapy after surgical salvage. Three days after flap salvage, the subject was once again brought back to the operating room for surgical exploration when a leech was witnessed to migrate beneath the threatened free flap. Duplex ultrasound was used intra-operatively to localize the leech 12 cm from its bite and assist with its successful removal. Tunneling of the leech beneath the flap is a rare complication, and localization underneath a myofascial or myocutaneous flap may be difficult. Duplex ultrasound is a simple and reliable method to localize the leech and allow for its removal through a minimal access incision.
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Affiliation(s)
- Garry Martin
- Department of Plastic Surgery, University of Kansas Medical Center, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Joshua D Linnell
- Department of Plastic Surgery, University of Kansas Medical Center, University of Kansas Medical Center, Kansas City, KS
| | - Susan S Yang
- Department of Plastic Surgery, University of Kansas Medical Center, University of Kansas Medical Center, Kansas City, KS
| | - James Lin
- Department of Otolarynoglogy-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Paul J Camarata
- Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS
| | - Brian T Andrews
- Department of Plastic Surgery, University of Kansas Medical Center, University of Kansas Medical Center, Kansas City, KS.,Department of Otolarynoglogy-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, KS
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18
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Fedor PJ. Novel Use of a Hemostatic Dressing in the Management of a Bleeding Leech Bite: A Case Report and Review of the Literature. Wilderness Environ Med 2012; 23:44-8. [DOI: 10.1016/j.wem.2011.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 09/15/2011] [Accepted: 10/20/2011] [Indexed: 11/24/2022]
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Singh AP. Medicinal leech therapy (Hirudotherapy) : A brief overview. Complement Ther Clin Pract 2010; 16:213-5. [DOI: 10.1016/j.ctcp.2009.11.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 10/01/2009] [Accepted: 11/25/2009] [Indexed: 10/19/2022]
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