• 대한두경부종양학회지
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• 제16권1호
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• pp.20-25
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• 2000

The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

• 셀메드
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• 제9권3호
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• pp.6.1-6.5
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• 2019

Unani system of medicine provides comprehension about the state of human body while in health and during turn down of health. Unani system strives to find the best methods to leads a healthy life with minimal or zero risk of any sickness additionally, the treatment is not only done through unani formulations but also by the regimenal therapies (Tadabeer) like Cupping (Hijamah), Leeching (Taleeq), Venesection (Fasd), Massage (Dalak), Exercise (Riyazat) etc. Massage (Dalak) is widely practiced regimens, which are used for restrorative, preventive as well as for therapeutic purposes. Almost all the civilizations having evidences about the use of massage in their manuscripts to improve impure blood or impurities from the body. Massage (Dalak) found to be effective in treatment of neurological and musculoskeletal disorders. Ibn Rushd stated that Massage (Dalak) is a type of exercise used for the removal of toxins or waste metabolites from the body. According to the disease, Massage (dalak) should be done in different parts of body and with different types of oils (roganiyat) and single drugs (mufrid advia).

• Archives of Aesthetic Plastic Surgery
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• 제23권3호
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• pp.143-145
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• 2017

Medical leech therapy is a treatment for the venous congestion of tissue flaps, grafts, and replants. We report a case of methicillin-resistant Staphylococcus aureus (MRSA) following leech application at a congested flap after mastectomy. A 45-year-old woman had an invasive ductal carcinoma. Modified radical mastectomy was performed. The chest wall defect was reconstructed with a local rotation flap. On postoperative day (POD) 1, congestion and color change were observed, and 10 medical leeches were applied to the congested area. On POD 4, another 10 medical leeches were applied. On POD 12, wound necrosis progressed and a pus-like discharge appeared. A wound swab culture revealed MRSA. Debridement was carried out on POD 15. From POD 16, vancomycin and piperacillin/tazobactam were injected for 18 days. The wound culture on POD 18 also revealed MRSA. A split-thickness skin graft was performed on POD 28. MRSA has not been clearly identified in the literature as a leech enteric bacterium. Although MRSA may have come from another source, the present case raises the possibility of MRSA infections following leech application at congested flaps. When medical leeches are applied at the congestion site of a flap, an aseptic cradle will be helpful. Vancomycin irrigation may be needed if infection occurs.