The use of the medicinal leech, Hirudo medicinalis, in the reconstructive plastic surgery

Abstract

The medicinal leech, Hirudo medicinalis, is being used to salvage compromised microvascular free-tissue transfers, replanted digits, ears, lips and nasal tips due to venous congestion. Twenty-three patients, 8-79 years old presenting with venous congestion of revascularized or replanted fingers, free or local flaps were treated by leech therapy. Of the 15 fingers, 10 fingers were saved (4 out of 9 replanted fingers and 6 out of 6 revascularized fingers), while 17 out of 18 flaps were salvaged (3 out of 4 free flaps and all 14 island and random flaps). Fifteen patients received 1-13 units of packed blood cells (average 2.9). The patients with revascularized or replanted fingers were treated in average of 2.5 days and each finger was treated with an average of 5.7 leeches. The 15 patients with flaps were treated in average of 3.4 days and each flap was treated with an average of 9.2 leeches.