• Journal of Pharmacopuncture
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• v.13 no.1
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• pp.103-120
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• 2010

Objective : To review the trend of the study related to Leech therapy and to establish the hereafter direction for the study on Leech therapy. Methods : I reviewed and analyzed all the theses published in Domestic and Foreign research institution from 1990 to 2009. Results : The following results were obtained in this study. 1. Analyzed number of theses published, there was no significance per year. 2. Classified by theme of journal, journals related to surgery were most(41 journals, 75.92%) among 54 kinds. 3. Classified by theses by research method and thesis types, case report accounted for nearly twothirds (52 pieces, 68.42%) of all theses and consideration of document was next(9 pieces, 11.84%). 4. With the most case of venous congestion after plastic and reconstructive surgery(33 pieces, 63.46%), leech therapy was effective on illnesses such as haematoma, macroglossia, purpura, varicous vein, avulsion injury, neurovascular compression, diabetic neuropathy, penoscrotal oedema, buerger's disease, rheumatoid arthritis. 5. Two most appeared adverse effects were anemia and infection. Immediate blood transfusion was done for recovering anemia and prophylactic 3rd generation antibiotics to infection were emphasized in more than half of case reports. 6. All of consideration of documents was retrospective study of cases related leech therapy and 3 pieces of them emphasized prophyratic antibiotic treatment for preventing infection. 7. The study of clinical trail type started first in 2002 and osteoarthritis of knee and carpometacarpal joint were main target. As see above result, Leech therapy was effective cure and could be used in disease induced by venous congestion. And I think that it is necessary to perform additional study related to solution of problems about leech therapy and protocol for using in clinical practice.

• Journal of Pharmacopuncture
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• v.12 no.2
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• pp.91-98
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• 2009

Objective : The purpose of this case is to show a case of buerger's disease improved by leech therapy. Methods : The patient received Leech Therapy and Oriental medical therapy(acupuncture and herb medicine). Result : We evaluate through visual analog scale(VAS), neuropathic total symptom score(TSS), fontaine grade and picture of patient's foot. Conclusion : Leech therapy and Oriental medical therapy had a good effect on buerger's disease.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.3
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• pp.135-146
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• 2009

Objectives : The purpose of this study is to report the effect of live leech(hirudo medicinalis) therapy with oriental medication on the patient with regional rheumatoid arthritis. The patient had resistant to DMARDs so she was in the debilitating condition and suffered from edema, pain, stiffness of joint and purpura before live leech(hirudo medicinalis) therapy. Methods : The regional rheumatoid arthritis patient had edema, pain, stiffness of joint and purpura on right foot. We treated the patient with live leech(hirudo medicinalis) therapy and oriental medicine. Results : The symptoms of regional rheumatoid arthritis was improved through live leech(hirudo medicinalis) therapy and oriental medicine. The patient maintains her condition with oriental medicine treatment after stopped all DMARDs such as MTX(methotrexate) and NSAIDs. After this treatment the patient's walking difficulty has been improved. Conclusions : This study shows that live leech(hirudo medicinalis) therapy and oriental medicine can elevate the regional rheumatoid arthritis patient's quality of life with continuous health care and treatment for major problem. For more accurate studies, further studies would be needed with more cases.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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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.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.158-163
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• 2000

Over the past several years, countless patients have benefitted from the use of leeches in microsurgery. As we know, leeches are used to overcome the problem of venous congestion by creating prolonged localized bleeding uniquely characteristics of leech bite. Venous congestion, a common complication of digital replantation, often has been treated through surgical repair like arteriovenous anastomosis. The leech produces a number of important substances which contribute to the special property of the bite, including an anticoagulant, a local vasodilator and local anesthetics. The bite usually bleeds for 1 to 2 hours and under special circumstances may bleed for up to 24 hours. So venous congestion is relieved. However, leeches increase the possibility of infection through their gut content. Infection associated medical leech application is significant risk. Other risk include allergic reaction, adverse psychologic reaction and blood loss requiring transfusion. The 65 cases of medical leech application were performed between August, 1997 and May, 2000 according to an established protocol. The complication were 18 cases ; infection (13 cases), hemorrhage (2 cases), allergic reaction (1 case), psychologic problem (1 case) and hypochromic anemia (1 case). Then our study was performed on the base of indication. As a result, Aeromonas hydrophilia was cultured from gut of medical leech and Klebsiella, Staphylococcus and Pseudomonas were cultured from media. We present the clinical risk-benefit of the medical leech therapy through several cases following digital replantation.

• Archives of Plastic Surgery
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• v.51 no.3
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• pp.317-320
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• 2024

Several strategies for the management of venous congestion of the nipple-areola complex (NAC) after reduction mammaplasty have been proposed. Among these, hirudotherapy represents an ancient but still effective method, even though the risk of infections related to leeches should be considered. We report a peculiar case of breast infection and sepsis after leech therapy in a patient who underwent a reduction mammaplasty. A prompt surgical debridement of the wounds and necrotic tissues associated with targeted antibiotic therapy led to a fast improvement of clinical conditions, and partial preservation of the NAC was obtained. Accurate knowledge of the clinical presentation of soft tissue infections related to leeching allows for an early diagnosis and would serve as a warning for surgeons who approach such breast cosmetic procedures.

• Archives of Aesthetic Plastic Surgery
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• v.23 no.3
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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.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.64-70
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• 1999

Digit that were formerly assessed as non replantable may now be replanted with the help of salvage procedure. In case that, venous repair is either marginal or technically impossible and postoperative venous congestion developed following replantation, are treated with the application of medical leeches. From July 1997 to April 1998, the authors performed arterial anastomosis and venous drainage using medical leeches in 3 children(The age of the patients ranged from 13 months to 6 years.) to have a result of aesthetic and functional success with minimizing the complications. Leech therapy has many advantages, to avoid injuring of finger tip, to decrease focal capillary coagulation, to prevent severe bleeding, and to prevent thromboembolism. The authors conclude that the use of medical leeches shows promise as a safe and effective method of providing temporary venous drainage in replanted digits.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.10-14
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• 1999

Ear reconstruction is very difficult to perform and often results in a devastating deformity. The use of microsurgical replantation techniques has allowed very favorable anesthetic results. We report a case of a partial ear replantation without venous repair with the use of medicinal leeches to decompress the acute venous congestion during the postoperative care. The medicinal leech therapy can be very useful in a partial ear replantation in cases with no venous repair.

• The Journal of Korean Medicine
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• v.24 no.4
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• pp.136-138
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• 2003

Purpose : A clinical case of diabetic foot-wound repair using Hirudo medicinalis therapy and its application is reported and discussed. Methods : The subject was a sixty-six-year-old woman diagnosed with a non-healing wound indicating the amputation of her right diabetic foot. Instead, Hirudo medicinalis therapy was performed twelve times over forty days, twice a week. The transition of wound closure was observed with the naked eye, and the plethysmogram was measured at the beginning and end of the treatment period. Results : The wound contracted with decreased exudate, collagen-like connective tissue sprouted, and then the wound gradually closed. The initial value (-0.08) of the dicrotic elastic index rose to -0.03. Conclusion : Hirudo medicinalis therapy had a positive effect on the wound repair, without a negative effect on the circulation, allowing the foot to be saved. It is necessary to investigate its wound repair mechanism for the further development of the Sahyul method.