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[Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review].
Handchir Mikrochir Plast Chir. 2007 Apr; 39(2):103-7.HM

Abstract

Medical leech therapy has enjoyed a renaissance in the world of reconstructive microsurgery during recent years. Especially venous congestion is decreased using hirudo medicinalis application such as following replantation of amputated fingers or congested flaps. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. Living in symbiosis with Aeromonas hydrophila, who can digest the sixfold blood meal related to their body weight, and a broad number of anticoagulant agents such as the thrombin inhibitor hirudin, apyrase as well as collagenase, hyaluronidase, Factor Xa inhibitor and fibrinase I and II, leeches decrease venous congestion. Laser Doppler flowmetry could demonstrate a significant increase in superficial skin perfusion following leech application 16 mm around the biting zone. Following the initial blood meal accounting for about 2.5 ml, the anticoagulant effect of the various leeches enzymes follows within the next 5-6 hours, which both account for the beneficial effects. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20 % and a chinolone antibiotic is currently recommended to face the potential Aeromonas hydrophila infection. Anemia is a second adverse effect during medicinal leech application which has to be taken account with repetitive blood samples. Besides the successful applications of leeches in various applications in plastic and reconstructive microsurgery, randomized-controlled trials are pending to elucidate the value of hirudo medicinalis according to evidence-based criteria above from case series and case studies.

Authors+Show Affiliations

Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover. kknobi@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article
Review

Language

ger

PubMed ID

17497605

Citation

Knobloch, K, et al. "[Hirudo Medicinalis-leech Applications in Plastic and Reconstructive Microsurgery--a Literature Review]." Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V..., vol. 39, no. 2, 2007, pp. 103-7.
Knobloch K, Gohritz A, Busch K, et al. [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review]. Handchir Mikrochir Plast Chir. 2007;39(2):103-7.
Knobloch, K., Gohritz, A., Busch, K., Spies, M., & Vogt, P. M. (2007). [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review]. Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V..., 39(2), 103-7.
Knobloch K, et al. [Hirudo Medicinalis-leech Applications in Plastic and Reconstructive Microsurgery--a Literature Review]. Handchir Mikrochir Plast Chir. 2007;39(2):103-7. PubMed PMID: 17497605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review]. AU - Knobloch,K, AU - Gohritz,A, AU - Busch,K, AU - Spies,M, AU - Vogt,P M, PY - 2007/5/15/pubmed PY - 2007/7/10/medline PY - 2007/5/15/entrez SP - 103 EP - 7 JF - Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... JO - Handchir Mikrochir Plast Chir VL - 39 IS - 2 N2 - Medical leech therapy has enjoyed a renaissance in the world of reconstructive microsurgery during recent years. Especially venous congestion is decreased using hirudo medicinalis application such as following replantation of amputated fingers or congested flaps. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. Living in symbiosis with Aeromonas hydrophila, who can digest the sixfold blood meal related to their body weight, and a broad number of anticoagulant agents such as the thrombin inhibitor hirudin, apyrase as well as collagenase, hyaluronidase, Factor Xa inhibitor and fibrinase I and II, leeches decrease venous congestion. Laser Doppler flowmetry could demonstrate a significant increase in superficial skin perfusion following leech application 16 mm around the biting zone. Following the initial blood meal accounting for about 2.5 ml, the anticoagulant effect of the various leeches enzymes follows within the next 5-6 hours, which both account for the beneficial effects. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20 % and a chinolone antibiotic is currently recommended to face the potential Aeromonas hydrophila infection. Anemia is a second adverse effect during medicinal leech application which has to be taken account with repetitive blood samples. Besides the successful applications of leeches in various applications in plastic and reconstructive microsurgery, randomized-controlled trials are pending to elucidate the value of hirudo medicinalis according to evidence-based criteria above from case series and case studies. SN - 0722-1819 UR - https://www.unboundmedicine.com/medline/citation/17497605/[Hirudo_medicinalis_leech_applications_in_plastic_and_reconstructive_microsurgery__a_literature_review]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-965138 DB - PRIME DP - Unbound Medicine ER -