Use Of Medicinal Leeches Research Articles

Therapeutic Potentials of Medicinal Leech in Chinese Medicine.

The use of medicinal leeches in clinical therapy has been employed for a long time, as it was originally recognized for exerting antithrombin effects. These effects were due to the ability of the leech to continuously suck blood while attached to human skin. According to Chinese Pharmacopoei, leeches used in traditional Chinese medicine mainly consist of Whitmania pigra Whitman, Hirudo nipponia Whitman, and Whitmania acranulata, but the latter two species are relatively scarce. The main constituents of leeches are protein and peptide macromolecules. They can be categorized into two categories based on their pharmacological effects. One group consists of active ingredients that directly target the coagulation system, such as hirudin, heparin, and histamine, which are widely known. The other group comprises protease inhibitor components like Decorsin and Hementin. Among these, hirudin secreted by the salivary glands of the leech is the most potent thrombin inhibitor and served as the sole remedy for preventing blood clotting until the discovery of heparin. Additionally, leeches play a significant role in various traditional Chinese medicine formulations. In recent decades, medicinal leeches have been applied in fields including anti-inflammatory treatment, cardiovascular disease management, antitumor treatment, and many other medical conditions. In this review, we present a comprehensive overview of the historical journey and medicinal applications of leeches in various medical conditions, emphasizing their pharmaceutical significance within traditional Chinese medicine. This review offers valuable insights for exploring additional therapeutic opportunities involving the use of leeches in various diseases and elucidating their underlying mechanisms for future research.

Utilization of Leech Therapy after Rhinoplasty.

The use of medicinal leeches in modern reconstructive surgery is well-described. Leech therapy after rhinoplasty has not been previously well-characterized. The medical records of all patients who underwent open rhinoplasty by a single surgeon over a 4-year period were reviewed. Patient demographics, including age, sex, medical comorbidities, number of previous rhinoplasty surgeries, time to utilization of leech therapy, adjunct therapies used, resolution of skin changes, and smoking status, were recorded. Operative reports were reviewed for pertinent information, including number of tip grafts used, graft materials used, and placement of septal extension grafts or "unicorn" grafts. Between April of 2016 and March of 2020, 545 patients underwent rhinoplasty performed by the senior author (P.S.N.). Of these patients, 39 (7.2 percent) underwent leech therapy postoperatively. The mean age of included patients was 47.4 years. Of the patients who required leech therapy, 34 (87.2 percent) had undergone revision rhinoplasty. The mean number of previous rhinoplasties was 3.4. The mean number of tip grafts used was 2.6. Thirty-three patients (84.6 percent) had either a traditional septal extension graft or unicorn graft placed. Nine patients (23.1 percent) were former smokers. Complete resolution of skin color changes was seen in 38 patients (97.4 percent). There were no major complications after leech therapy. Leech therapy is a useful tool for the rhinoplasty surgeon, particularly in the setting of complex revision rhinoplasty, in patients who have undergone multiple previous nasal surgical procedures, or in patients who require significant cartilage grafting to reconstruct the nasal tip or lengthen the nose. Therapeutic, IV.

Some aspects of hirudotherapy in treatment of varicose disease (literature review)

The article describes the data on the use of medicinal leeches in the treatment and prevention of blood clots and the effectiveness of hirudin in varicose veins of the lower extremity. The article also contains information on the mechanism of action of hirudin at all stages of coagulation and the anticoagulant system of the body. The result of the effect of hirudin on already formed blood clots is shown.

Tıbbi Sülük Terapisi (Hirudoterapi)

Sülükler halkalı omurgasızlar sınıfındadır, kan ile beslenirler ve antik dönemden beri çeşitli hastalıkları tedavi etmek için flebotomide kullanılırlar. Hirudoterapi, tedavi için tıbbi sülüklerin uygulanmasıdır. Sülük tedavisinin terapötik kullanımı köklü bir yöntemdir ve eski Mısır'a, medeniyetin başlangıcına dayanır. 20. yüzyılın sonunda yeni terapi kavramları sülük tedavisinin yerini almıştır. Mikrovasküler cerrahi tekniklerle birlikte son yıllarda tıbbi sülüklerin kullanımında bir “yeniden doğuş” olmuştur. Hirudo medicinalis, sülükler arasında en geniş terapotik kullanıma sahiptir ancak dünya çapında birçok farklı tür test edilmiş ve incelenmiştir. Sülük tedavisi genellikle ağrısız olan bir ilk ısırığı, ardından 5 ila 15 ml kan emmeyi içerir. Başlıca terapötik faydaları sadece ısırma sırasında emilen kandan değil, aynı zamanda çeşitli biyoaktif maddelerden de kaynaklanmaktadır. Sülük tükürüğü; eglin, bdellin, hirudin, hyaluronidaz, calin, destabilas, apiraz, dekorin, hirustatin, triptaz inhibitörleri ve histamin benzeri maddeler, kompleman inhibitörleri, karboksipeptidaz A-inhibitörleri ve asetilkolin gibi çeşitli biyoaktif bileşikler içerir. Bu bileşikler; koagülasyonun inhibisyonundan, analjezik etkiden, kas gevşetici etkiden ve bağışıklık sistemi üzerindeki düzenlemeden sorumludur. Hirudoterapi; kardiyoloji, ortopedi, jinekoloji, oftalmoloji, plastik ve rekonstrüktif cerrahi gibi alanlarda geniş bir terapötik uygulama yelpazesine sahiptir. Bu derleme sülükler hakkında; tarihçesi, genel özellikleri, etki mekanizmaları ve tıbbi bir cihaz olarak uygulanmasını içeren genel bir bakış sunar.

The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits.

A noteworthy cause of failure in digital replantation is venous insufficiency. External bloodletting with medicinal leeches is a common treatment for venous insufficiency after distal digital replantations. The objective of this study was to evaluate the salvage rate of digits replanted proximal to the distal interphalangeal (DIP) joint that were treated with medicinal leeches for venous congestion. We retrospectively reviewed the charts of patients with complete or incomplete digit amputation admitted between January, 2008 and April, 2014. We included all patients with venous congestion in one or more digits replanted or revascularized at the middle or proximal phalangeal level, who were treated with medicinal leeches. Treatment initiation and duration were based on clinical judgment. Demographic, therapy, and surgical data werecollected. Of 145 patients with 205 digits that were replanted or revascularized, 25 digits were treated with medicinal leeches for venous congestion. Venous congestion was diagnosed later than 48 hours after operation in 24 of the 25 digits. Of the 25 digits, 11 survived (44.4%) (8 of 22 replanted digits and all 3 revascularized digits). No complications were recorded except for substantial blood loss requiring transfusion in one patient. External bloodletting with medical leeches might be less effective with late treatment or with a higher volume of congested tissue, as is characteristic of proximal finger replantation. Therapeutic IV.

Hirudo medicinalis - historical and biological background and their role in microsurgery: Review article

The first recorded use of medicinal leeches has known from ancient Egypt. There was more widespread written reference to their employment in the first century AD. In the 1980s, French surgeons utilized leeches to maintain venous circulation in distal finger replantations that were subject to arterial anastomosis. Leeches are currently used in hirudotherapy, microvascular replantation, reconstructive surgery, and the treatment of venous congestion that takes place upon trauma surgery. In this paper, hirudotherapy is presented for plastic surgery and discussed are the related complications and benefits.

Use of Primary Sutures to Stop Persistent Bleeding due to Hirudotherapy

Introduction: The use of medicinal leeches for treatment purposes is known as hirudotherapy. Hirudotherapy has long been used in traditional medicine for the treatment of chronic pain, particularly in the back and knees. However, it may cause complications such as local infections, allergy, and continued bleeding. This report discusses the effectiveness of primary sutures in controlling continued bleeding caused by hirudotherapy in three patients who presented to the emergency department.Case Report: Three patients presented to the emergency department because of bleeding in the region of where leeches were used for treating back pain. Vital signs of the patients were normal and have any diseases. Persistent bleeding stopped after primary suturing of the wounds. Conclusion: Indications and contraindications of hirudotherapy should be identified in a detail by researches. Practitioners of this therapy should be informed of the use and removal of leeches to prevent the occurrence of complications

Flap Infection Associated with Medicinal Leeches in Reconstructive Surgery: Two New Drug-Resistant Organisms

The use of medicinal leeches in reconstructive surgery has proven value for the salvage of flaps with venous congestion but is associated with a risk of leech-acquired infection. The most common leech-associated organism is Aeromonas hydrophila, which antibiotic prophylaxis is typically directed against. The authors describe two new multidrug-resistant organisms acquired from medicinal leech therapy that resulted in flap infection. The evaluation of suspected leech-borne infection and management protocol for this leech-acquired resistant multi-organism infection is presented.

Medicinal leeches and the microsurgeon: A four‐year study, clinical series and risk benefit review

There are case reports and small series in the literature relating to the use of medicinal leeches by plastic surgeons; however, larger series from individual units are rare. The aim of this article is to present a comprehensive 4-year case series of the use of medicinal leeches, discuss the current evidence regarding indications, risks, and benefits and highlight the recent updates regarding leech speciation. Patients prescribed leeches in a 4-year period (July 2004-2008) were collated from hospital pharmacy records (N = 35). The number of leeches used, demographic, clinical, and microbiological details were retrospectively analyzed. Thirty-five patients were treated with leeches. The age range was 2 to 98 years (mean = 49.3). Leeches were most commonly used for venous congestion in pedicled flaps and replantations. Blood transfusions were necessary in 12 cases (34%) [mean = 2.8 units, range 2-5 units]. Our infection rate was 20% (7/35) including five infections with Aeromonas spp. (14.2%). The proportion of patients becoming infected after leech therapy was significantly greater in the group of patients that did not receive prophylactic antibiotic treatment (Fisher's Exact test P = 0.0005). In total, 14 cases (40%) were salvaged in entirety, in 7 cases 80% or more, in 2 cases 50 to 79%, and in 1 case less than 50% of the tissues were salvaged. In 11 cases (31%), the tissues were totally lost. Our study highlights both the benefits and the risks to patients in selected clinical situations and also the potential risks. The routine use of antibiotic prophylaxis is supported. In view of the emerging evidence that Hirudo verbana are now used as standard leech therapy, and the primary pathogen is Aeromonas veronii, until a large prospective multicenter study is published, large series of patients treated with leeches should be reported.

Leech-Transmitted Ciprofloxacin-Resistant Aeromonas hydrophila

The use of medicinal leeches ( Hirudo medicinalis ) is effective in establishing venous outflow in congested flaps and replants.Leech therapy also has associated risks, including significant blood loss requiring transfusions and infections from Aeromonas , a gram-negative bacilli.Leeches maintain a symbiotic relationship with Aeromonas species, which are resident to their gut in order to digest blood. Aeromonas hydrophila infections can result in extensive soft-tissue infections and myonecrosis.To prevent this devastating nosocomial infection, ciprofloxacin and/or trimethoprim-sulfamethoxazole (TMP-SMX) are the most commonly used prophylactic antibiotics when patients undergo leech therapy.

Medicinal leeches for the treatment of venous congestion and hematoma after plastic reconstructive surgery

Leeches were used for medical purposes as long as 2 000 years ago in ancient Egypt. In recent years the use of medicinal leeches became rather popular again, e. g. to improve blood circulation in ischemic tissue after reconstructive plastic surgery. In a single center, retrospective study 23 consecutive cases were analyzed in which medicinal leeches had been used therapeutically after plastic reconstructive surgery. All cases were categorized regarding the indication for leech therapy, the onset, the duration, the number of leeches and the number of sessions. Among the group of patients there were 7 female and 16 male patients with a mean age of 73 ± 14 years (48-94 years) altogether. The main indications were venous congestion (12/23; 52 %) and hematoma (9/23; 39 %). Two cases were diagnosed with a necrosis of the tip of the flap and therefore received leech therapy (2/23; 9 %). The average number of leeches was 2.6 leeches/session, the number of sessions was 1.7 ± 0.8. 20/23 patients (87 %) showed a restitutio ad integrum after leech therapy, in 3/23 patients (13 %) a necrosis of the tip of the flap could not be prevented. A clinical improvement was noticed after an average of 1.1 ± 0.3 days. The early application of medicinal leeches can improve local hemodynamic conditions. Leech therapy is a simple and effective method; the cost efficiency of the treatment is high.

Medicinal Leech Use in Microsurgery

Physicians have used the medicinal leech (Hirudo medicinalis) for centuries. Indeed, the etymology of the word leech shows it is a derivative of the Anglo-Saxon term laece, meaning physician. The earliest recorded use of the medicinal leech was depicted graphically in ancient Egypt (1567–1308 bce), and written records date to 200 to 130 bce. Their use has varied substantially over the past 3500 years, with indications ranging from treatment of sexually transmitted diseases to tuberculosis, kidney disease, and arthritis. Their use waned until the 1960s, when they were used to salvage tissues that were endangered from venous congestion 1 Whitaker I.S. Rao J. Izadi D. Butler P.E. Historical article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history. Br J Oral Maxillofac Surg. 2004; 42: 133-137 Abstract Full Text Full Text PDF PubMed Scopus (112) Google Scholar after replantation. Educational Objectives •Discuss the history of the use of the medicinal leech. •State the biomechanical compound in leech saliva responsible for anticoagulation. •Discuss the factors that affect the amount of active and passive blood loss during leech therapy. •State the role and outcome of leeches in venous congestion following tissue transfer. •Describe the main complication following leech therapy. Earn up to 2 hours of CME credit per JHS issue when you read the related articles and take the online test. To pay the $20 fee and take this month's test, visit http://www.assh.org/professionals/jhs. •Discuss the history of the use of the medicinal leech. •State the biomechanical compound in leech saliva responsible for anticoagulation. •Discuss the factors that affect the amount of active and passive blood loss during leech therapy. •State the role and outcome of leeches in venous congestion following tissue transfer. •Describe the main complication following leech therapy. Earn up to 2 hours of CME credit per JHS issue when you read the related articles and take the online test. To pay the $20 fee and take this month's test, visit http://www.assh.org/professionals/jhs. Journal CME QuestionsJournal of Hand SurgeryVol. 35Issue 6Preview Full-Text PDF

Ciprofloxacin resistant Aeromonas infection following the use of Medicinal Leeches

Ciprofloxacin resistant Aeromonas infection following the use of Medicinal Leeches

Infection risk related to the use of medicinal leeches

To assess the incidence of postoperative wound infections related to treatment with medicinal leeches at Ghent University Hospital. A 2-year retrospective analysis of bacteriologic culture results of soft tissue infections in patients treated with medicinal leeches. Cultures of suspected wound infections were taken and susceptibility testing of isolates was performed on 17 of 47 patients (36.2%). Aeromonas was frequently isolated (18.5%). A high incidence of infection during and after application of medicinal leeches, despite their external decontamination, necessitates an antibiotic prophylaxis. In particular Aeromonas must be covered, as soft tissue infections with these bacteria can give serious complications. The prophylactic antibiotic should cover the most frequent isolated species taking into account the importance of Aeromonas and the susceptibility pattern. Based on the results, fluoroquinolones seem to be a good choice. The authors believe that practical recommendations to hospital pharmacists on prophylaxis during Hirudo medicinalis treatment, might enhance the safety of it's use by reducing the number of infections.

Meningococcal purpura fulminans treated with medicinal leeches

Meningococcal septicemia remains one of the most common infectious causes of admission to a pediatric intensive care unit. Numerous treatment strategies aimed at the thromboembolic complications inducing purpura fulminans and limb/digital ischemia have been attempted, with variable results. The successful use of medicinal leeches for pneumococcal purpura fulminans has been described, and we present a similar case of meningococcal purpura fulminans. A 5-wk-old female infant with meningococcal meningitis and septicemia and progressive purpura fulminans of the left hand was treated with medicinal leeches. Medicinal leeches were applied to the left dorsal hand on a daily basis for 4 consecutive days. The swelling and limited functionality visibly improved after 48 hrs, and by 120 hrs, perfusion in the distal phalanges of the thumb and middle finger was evident. Reperfusion of the distal phalanges was not fully sustained, and at 6 wks the plastic surgery department debrided the distal phalanges of her left hand, excluding the thumb. She fully recovered from the meningococcal septicemic shock; the functionality of her left thumb was preserved, and she has limited functionality of her left hand. The unique combination of salivary products in leech therapy has theoretical benefits and requires future study.

Historical Article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history

Blood letting and the therapeutic use of Hirudo medicinalis date back to ancient Egypt and the beginning of civilisation. Their popularity has varied over the years, reaching such a peak in Europe between 1825 and 1850 that supplies were exhausted. Towards the end of the century they fell out of favour and, during this period, the leech, once used by the physicians of emperors and influential academic surgeons, became associated with lay therapists and quackery. Leeches have enjoyed a renaissance in reconstructive microsurgery during the last 15 years, having been used by maxillofacial [Br. J. Oral Maxillofac. Surg. 41 (2003) 44] and other reconstructive surgeons to aid salvage of compromised microvascular free tissue transfers [Laryngoscope 108 (1998) 1129; Br. J. Plast. Surg. 34 (1984) 358], replanted digits [Int. J. Microsurg. 3 (1981) 265], ears [Ann. Plast. Surg. 43 (1999) 427], lips [Plast. Reconstr. Surg. 102 (1998) 358; J. Reconstr. Microsurg. 9 (1993) 327] and nasal tips [Br. J. Oral Maxillofac. Surg. 36 (1998) 462]. Peer-reviewed evidence suggests that the survival of compromised, venous-congested tissues is improved by early application of a leech [J. Reconstr. Microsurg. 12 (1996) 165; Arch. Otolaryngol. Head Neck Surg. 114 (1988) 1395; Br. J. Plast. Surg. 45 (1992) 235]. Leeches have also recently been used to treat a wide range of conditions, including periorbital haematomas [Br. J. Ophthalmol. 75 (1991) 755], severe macroglossia [Otolaryngol. Head Neck Surg. 125 (2001) 649; J. Laryngol. Otol. 109 (1995) 442] and purpura fulminans [Ann. Plast. Surg. 35 (1995) 300]. The first medicinal leech farm, Biopharm, was set up in Swansea in 1981 by Dr Roy Sawyer, and now supplies leeches to hospitals all over the world. In this paper, we summarise the history of treatment with Hirudo medicinalis from its origin to the present day, and take a brief look at the possible future of the annelid.

Immediate use of medicinal leeches to salvage venous congested reverse pedicled neurocutaneous flaps

Reverse pedicled neurocutaneous flaps have recently become popular for reconstructing soft tissue defects of the lower extremity. Venous congestion is a relatively common problem in these flaps in diabetic patients and those with electric burns, and this may cause partial or complete loss if capillary perfusion is not re-established urgently. We describe our experience of 13 neurocutaneous flaps, of which five developed venous congestion and were treated successfully with leeches placed immediately.

The use of medicinal leeches to treat macroglossia secondary to blunt trauma

The use of medicinal leeches to treat macroglossia secondary to blunt trauma

Aeromonas Infection After Medicinal Leech Therapy: Case Reports and Review of the Literature

Aeromonas Infection After Medicinal Leech Therapy: Case Reports and Review of the Literature

Clinical and scientific considerations in leech therapy for the management of acute venous congestion: an updated review.

Any surgical intervention that involves the manipulation of veins, large or small, carries the risk of acute venous congestion. Venous congestion is the product of an imbalance between arterial inflow and venous outflow, and results in the stasis of blood in the tissues that are normally drained by the affected veins. The resultant lack of tissue perfusion causes hypoxia, acidosis, and arterial thrombi formation, which can potentially progress to tissue necrosis and wet gangrene. In the past several decades, the use of leeches (Hirudo medicinalis) has been rediscovered as an effective method of relieving acute venous congestion. This updated review of leech therapy focuses on the use of medicinal leeches in a variety of clinical conditions characterized by acute venous congestion, and points out the experimental use of leeches in other pathological entities. A discussion of the recent scientific findings that explain the possible mechanisms of action of leech therapy is also provided.