Utilization of Leech Therapy after Rhinoplasty
Research article published in Plastic and reconstructive surgery (2022)
Abstract
BACKGROUND: The use of medicinal leeches in modern reconstructive surgery is well-described. Leech therapy after rhinoplasty has not been previously well-characterized. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
The use of medicinal leeches in modern reconstructive surgery is well-described. Leech therapy after rhinoplasty has not been previously well-characterized.
Warum dies für die Hirudotherapie relevant ist
Diese Studie berichtet über die Erfahrungen eines einzelnen Chirurgen mit postoperativer Blutegeltherapie nach offener Rhinoplastik, bei der 39 von 545 Patienten (7,2 %) eine Blutegelbehandlung erhielten – überwiegend nach Revisionsverfahren (87,2 %) –, wobei bei 97,4 % eine vollständige Rückbildung der nachteiligen Hautverfärbungen beobachtet wurde und keine größeren Komplikationen auftraten. Diese Arbeit ist von direkter Relevanz für die Hirudotherapie, da sie klinische Outcome-Daten zum Einsatz medizinischer Blutegel in der plastischen Gesichtschirurgie liefert und die etablierte Rolle der Blutegeltherapie bei der Behandlung beeinträchtigter Gewebeperfusion in verschiedenen rekonstruktiven Kontexten untermauert. Die Ergebnisse spiegeln die Praxis und Patientenpopulation eines einzelnen Chirurgen wider, liefern keine Daten zu Blutegelarten, Komponenten des Speichelsekretoms oder den pharmakologischen Mechanismen, die den beobachteten klinischen Effekten zugrunde liegen, und etablieren keine optimalen Behandlungsprotokolle für eine breitere Anwendung.
Zitation
Utilization of Leech Therapy after Rhinoplasty.
Shtraks J, Peng G, Nassif P · Plastic and reconstructive surgery, 2022
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