The use of the medicinal leech, Hirudo medicinalis, in the r
In recent years, the medicinal leech, Hirudo medicinalis, has been used to aid salvage of compromised microvascular free-tissue transfers, replanted digits, ears, lips and nasal tips in the plastic surgery. The survival of compromised, venous-congested tissues was improved by early application of leeches.
In July 2004, the FDA approved leeches as a medical device in the area of plastic and reconstructive surgery. A survey of all 62 plastic surgery units in the United Kingdom and the Republic of Ireland showed that the majority of these units use leeches post-operatively.
In Israel, most of the studies on leeches are about the anti-coagulant properties of the leech saliva. Eldor et al. used this technique on 50 patients with congested skin flaps and in one patient with a reimplanted ear, as well as in 40 patients with post-phlebitic syndrome. In 52.5% of the patients the pain-relief was immediate and persisted for about three weeks while improved mobility was reported in 70% of them. Shenfeld used leeches for the treatment of venous insufficiency in a replanted digit.
We report the use of leeches in 23 patients with venous congestion either after revascularized or replanted fingers or after flap reconstructions....