About the Society
Nonprofit orientation. Clinically literate. Research-forward. Evidence over anecdote.
Last updated: March 14, 2026
Mission
The American Society of Hirudotherapy (ASH) exists to promote evidence-informed, safety-conscious hirudotherapy in the United States; to support clinical education and original research; and to build the infrastructure required for ethical, traceable use of medicinal leeches across American healthcare settings.
We curate and publish the most comprehensive, peer-reviewed evidence base for hirudotherapy available in English. We develop safety protocols, clinical guidelines, and educational resources for the surgeons, nurses, wound-care specialists, and researchers who use or study medicinal leeches. We advocate for supply chain integrity — from aquaculture to bedside — so that every leech applied to a patient is FDA-cleared, traceable, and handled under controlled conditions.
What We Do
Education
Publish evidence reviews, clinical protocols, and educational materials for healthcare professionals.
Standards
Develop safety protocols, competency frameworks, and best-practice guidelines.
Research Support
Facilitate clinical research, maintain an evidence registry, and support study design.
Supply Chain
Promote traceability, quality control, and ethical sourcing standards for medicinal leeches.
What We Do Not Do
- We do not sell leeches. We are an educational and standards organization, not a supplier. We maintain independence from commercial interests.
- We do not treat patients. We provide information and protocols to licensed healthcare professionals. We do not operate clinics or provide medical advice to individuals.
- We do not currently certify practitioners. No formal U.S. certification for hirudotherapy exists yet. We are developing a national certification program (see Training & Certification), but no credentials are issued at this time.
Mission Pillars
Evidence Discipline
Every clinical claim on this website is grounded in peer-reviewed literature. We use the GRADE framework to rate evidence quality and clearly distinguish strong evidence from preliminary findings. We never overstate what the data shows.
Safety First
Patient safety is non-negotiable. Our protocols address antibiotic prophylaxis, bleeding management, infection prevention, and adverse event reporting. We emphasize contraindications as prominently as indications.
Regulatory Clarity
We clearly distinguish between FDA-cleared indications and off-label uses. Every condition page on this site is tagged with a regulatory tier so clinicians can make informed decisions within appropriate institutional and legal frameworks.
Supply Chain Integrity
Medicinal leeches are FDA-cleared medical devices. Like any medical device, they require traceable sourcing, controlled storage, proper handling, and documented chain of custody. We develop and promote the standards that make this possible.
Open Science
We believe clinical knowledge should be freely accessible. This website is a public resource. We support open-access publication, data sharing, and collaborative research. Science advances fastest when information flows freely.
Vision
Long-Term Vision
A United States where medicinal leech therapy is practiced within a rigorous, transparent, evidence-based framework — where clinicians have access to high-quality protocols, researchers can build on a shared evidence base, and patients can trust that the therapy they receive meets the same standards as any other medical intervention.
Near-Term Goals (2025–2027)
- Publish a comprehensive English-language evidence resource for hirudotherapy
- Develop standardized safety protocols adoptable by U.S. hospitals
- Establish an advisory board with multidisciplinary clinical expertise
- Begin planning for CME-accredited educational programming
- Launch a clinical outcomes registry for voluntary reporting
- Develop aquaculture quality standards for medicinal leech production
Standards We Aspire To
Our evidence reviews follow CONSORT (for RCT reporting), STROBE (for observational studies), and PRISMA (for systematic reviews) reporting standards. Our clinical protocols are developed with reference to FDA guidance documents and relevant professional society guidelines.
Core Values
Evidence Over Anecdote
We base clinical recommendations on published, peer-reviewed evidence — not tradition, testimonials, or commercial claims. When evidence is weak, we say so explicitly.
Safety Before Efficacy
A treatment that works but harms patients is not a treatment. We prioritize safety assessment, contraindication awareness, and adverse event reporting.
Transparency as Default
Conflicts of interest are disclosed. Funding sources are public. Governance decisions are documented. We operate with the transparency expected of a public-interest organization.
Regulatory Compliance Always
Medicinal leeches are FDA-regulated medical devices. We operate within — and advocate for — the existing regulatory framework, not around it.
Patient Welfare First
Every protocol, guideline, and recommendation exists to improve patient outcomes. If the evidence does not support a use, we say so — even if it is commercially inconvenient.
Scientific Humility
We acknowledge what we do not know. Where evidence is preliminary, we label it as such. We welcome correction, critique, and new data that challenges existing conclusions.
Ethical Sourcing
Medicinal leeches are living organisms. Ethical aquaculture, humane handling, and environmental responsibility are integral to responsible practice.
Collaboration Over Competition
We partner with clinicians, researchers, institutions, and international organizations. The field advances through cooperation, not territorial claims.
Who We Serve
Plastic & Reconstructive Surgeons
Evidence-based protocols for flap salvage, digit replantation, and microsurgical reconstruction. Outcome data, nursing protocols, and complication management guidelines for the FDA-cleared indication.
Microsurgery Nursing Teams
Application technique guides, monitoring protocols, blood loss documentation standards, patient education materials, and complication recognition training resources.
Wound Care Specialists
Evidence reviews for chronic wound management, diabetic ulcer protocols, venous ulcer integration guidelines, and infection prevention strategies.
Research Scientists
Comprehensive evidence summaries, research gap analyses, study design considerations, and leech biology resources covering salivary compounds, microbiome, and pharmacology.
Hospital Administrators & Pharmacy
Institutional implementation guidance, policy template elements, supply chain management recommendations, regulatory compliance information, and cost-effectiveness data.
Patients & Caregivers
Accessible, evidence-based information about what hirudotherapy is, when it is appropriate, what to expect, and how to find qualified providers. We do not provide medical advice but help patients make informed decisions with their clinicians.
Leadership
Andrei Dokukin, MD
Founder & Clinical Director
Dr. Dokukin is a physician leader with extensive clinical experience in integrative medicine and a deep knowledge of hirudotherapy practice spanning both European and American clinical traditions. His medical training includes formal education in hirudotherapy protocols, patient safety systems, and evidence-based practice design.
As Founder and Clinical Director, Dr. Dokukin leads protocol development, safety standards creation, and evidence synthesis for the Society. He is responsible for clinical content review, ensuring that all published materials meet the “evidence over anecdote” standard central to the organization’s mission.
His focus areas include protocolized clinical integration of hirudotherapy into U.S. hospital settings, development of standardized safety monitoring protocols, and building the evidence pipeline needed to support expanded clinical applications.
Dmytro (Dmitry) Ronsal
Co-Founder & Main Bioengineer
Dmitry Ronsal brings engineering and systems-design expertise to the Society, with a focus on the biological infrastructure that underlies responsible hirudotherapy practice. His background combines technical engineering with hands-on aquaculture development and facility biosecurity design.
As Co-Founder and Main Bioengineer, Ronsal designs and operates the aquaculture systems, husbandry workflows, and biosecurity protocols that support medical-grade leech production. His work ensures that every stage of the supply chain — from breeding to bedside — meets the traceability and quality standards required for a regulated medical device.
His technical expertise spans facility design, controlled-environment aquaculture, breeding program management, FDA compliance documentation, and the data systems that support quality control and batch traceability.
Growing Team
Advisory Board
The Advisory Board is currently being established. We are recruiting advisors with expertise in the following disciplines:
Plastic & Reconstructive Surgery
Microsurgical flap salvage, digit replantation, clinical outcomes
Vascular Medicine
Venous disease, chronic venous insufficiency, post-thrombotic syndrome
Infectious Disease
Aeromonas management, antibiotic prophylaxis, surgical site infections
Regulatory Affairs
FDA device regulation, 510(k) compliance, institutional policy
Bioethics
Research ethics, informed consent, animal welfare in medical device sourcing
Aquaculture Science
Controlled-environment breeding, quality assurance, species conservation
Selection criteria: Clinical or scientific expertise, academic standing, publication record, and absence of disqualifying commercial conflicts of interest. All advisors will be required to complete annual conflict-of-interest disclosures, which will be publicly available.
Organizational Structure
ASH is organized as a California-based nonprofit with the goal of operating under 501(c)(3) tax-exempt status. Our governance model prioritizes evidence-based decision-making and independence from commercial interests.
Board of Directors
Fiduciary oversight, strategic direction, and financial accountability. Planned composition: 5-7 members with rotating terms.
Clinical Advisory Committee
Protocol review, safety standards, clinical content approval. Multidisciplinary membership with documented expertise requirements.
Scientific Review Board
Evidence evaluation, research methodology oversight, publication review. Planned for establishment as research activities expand.
What Makes Us Different
| Dimension | ASH Approach | Typical Alternative |
|---|---|---|
| Evidence standard | GRADE framework, peer-reviewed citations | Anecdotal, testimonial, tradition-based |
| Regulatory framework | FDA-aware, tier-labeled, compliance-oriented | Regulatory status often unstated or ignored |
| Commercial independence | Nonprofit, no leech sales, disclosed conflicts | Often linked to commercial suppliers |
| Clinical audience | Surgeons, nurses, researchers, administrators | General public, wellness enthusiasts |
| Safety emphasis | Contraindications, adverse events, antibiotic protocols | Safety minimized or unstated |
| Geographic focus | U.S. regulatory and clinical context | International or non-specific |
Strategic Priorities
Clinical Evidence Resources
Build and maintain a comprehensive, publicly accessible evidence base for hirudotherapy in the English language. Expand condition-specific pages, add systematic review summaries, and develop a searchable evidence database.
Safety Protocol Development
Publish standardized safety protocols for antibiotic prophylaxis, bleeding management, infection prevention, and adverse event reporting. Design protocols adoptable by any U.S. hospital with minimal customization.
Practitioner Education
Develop educational resources leading toward CME-accredited programming. Create competency frameworks for nurses, physicians, and allied health professionals involved in hirudotherapy administration.
Supply Chain Standards
Develop quality standards for medicinal leech aquaculture, storage, transport, and handling. Promote full batch traceability from breeding facility to patient application. Support FDA compliance across the supply chain.
Clinical Registry
Build infrastructure for voluntary outcome reporting by clinicians using leech therapy. Aggregate data on indications, protocols, outcomes, and adverse events to strengthen the evidence base through real-world data.
Research Partnerships
Establish collaborative relationships with academic medical centers, professional societies, and international hirudotherapy organizations. Support multicenter study design and coordinate research efforts to fill evidence gaps.
Locations
Operational Headquarters
9604 Artesia Blvd, Suite 104C, Bellflower, CA 90706 USA
Administrative offices and clinical coordination center. Located in the greater Los Angeles area.
Mailing Address
24001 Calle De La Magdalena, #2246, Laguna Hills, CA 92654 USA
Official correspondence, partnership inquiries, and document submissions.
Proposed Aquaculture Facility
Stanton, CA 90680 USA
Planned controlled-environment facility for medical-grade leech production, breeding program development, and quality assurance operations. Currently in planning and permitting stages.
Service area: Nationwide (educational resources and standards). California (operational facilities). Our online evidence resources are freely accessible from anywhere.
Governance & Ethics
We operate with audit-friendly transparency and a conservative evidence discipline. Our governance framework is designed to ensure that scientific integrity, patient safety, and regulatory compliance take precedence over organizational growth or commercial interests.
Conflict of Interest Policy
All board members, advisors, and content contributors are required to disclose financial and non-financial conflicts of interest annually. Disclosures are reviewed by the Board and made available on request. Contributors with material conflicts are recused from related decisions.
Scientific Integrity
Published content undergoes internal review for accuracy, balance, and citation quality. We do not publish content influenced by donors, sponsors, or commercial partners. Errors are corrected promptly with transparent correction notices.
Financial Transparency
As a nonprofit-oriented organization, we are committed to publishing annual financial summaries, program expenditure breakdowns, and funding source disclosures. Form 990 will be publicly available upon achieving 501(c)(3) status.
Editorial Independence
No clinical content on this website is influenced by donors, sponsors, advertisers, or commercial partners. Evidence is evaluated on its merits. Negative or inconclusive findings are reported with the same rigor as favorable results.
Full policy documents are available in our Documents Library, including conflict of interest policies, scientific integrity statements, and governance transparency disclosures.
History & Milestones
| Year | Milestone |
|---|---|
| 2004 | FDA clears medicinal leeches as a medical device (510(k) K040187), establishing the U.S. regulatory framework. |
| 2024 | Founding of the American Society of Hirudotherapy. Mission defined: evidence-based education, safety standards, and supply chain integrity. |
| 2025 | Launch of hirudotherapysociety.org with comprehensive clinical evidence reviews, leech biology section, safety protocols, and regulatory guidance. |
| 2025–26 | Content expansion: 130 evidence-based pages covering clinical conditions, leech biology, aquaculture, and regulatory frameworks. Advisory board formation in progress. |
Partnerships & Affiliations
ASH is in its early stages, and we are transparent about that. We are actively seeking partnerships with organizations that share our commitment to evidence-based practice and regulatory compliance.
Planned Partnerships
- • Academic medical centers (research collaboration)
- • Professional surgical societies
- • Wound care professional organizations
- • FDA engagement (device regulation)
- • International hirudotherapy organizations
Partnership Criteria
- • Commitment to evidence-based practice
- • Regulatory compliance
- • Transparency and conflict-of-interest disclosure
- • Patient safety prioritization
- • No requirement for content or editorial influence
Contact & Engagement
For Healthcare Professionals
- Research collaboration inquiries
- Clinical protocol feedback
- Content review and correction requests
- CME and educational programming interest
- Outcomes registry participation
For Patients & Caregivers
We do not provide clinical services or medical advice to individuals. However, our website is a comprehensive resource for understanding the evidence behind hirudotherapy. For clinical questions, please consult a qualified healthcare provider.
For all inquiries: Contact & Transparency.
Commitment to Accuracy
Content Standards
- • All clinical claims supported by peer-reviewed citations
- • Sources: PubMed-indexed journals, Cochrane reviews, FDA documents
- • GRADE framework for evidence quality rating
- • CONSORT/STROBE/PRISMA reporting standards followed
- • Regular content review and updating schedule
Correction Policy
- • Errors corrected promptly upon identification
- • Correction notices posted for substantive changes
- • “Last updated” timestamps on all clinical pages
- • Version history maintained in our documentation system
- • Community corrections welcome via contact page