American Society of Hirudotherapy

Clinical uses of the medicinal leech: a practical review

Review article published in Journal of postgraduate medicine (2011)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsPorshinsky B et al. · Journal of postgraduate medicine, 2011

Abstract

The medicinal leech, Hirudo medicinalis, is an excellent example of the use of invertebrates in the treatment of human disease. Utilized for various medical indications since the ancient times, the medicinal leech is currently being used in a narrow range of well-defined and scientifically-grounded clinical applications. Hirudotherapy is most commonly used in the setting of venous congestion associated with soft tissue replantations and free flap-based reconstructive surgery. This is a comprehensive review of current clinical applications of hirudotherapy, featuring a comprehensive search of all major medical search engines (i.e. PubMed, Google Scholar, ScientificCommons) and other cross-referenced sources. The authors focus on indications, contraindications, practical application/handling of the leech, and therapy-related complications.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnimalsHirudin TherapyHirudo medicinalisHumansHyperemiaLeechingReplantationSurgical Flaps

Summary

The medicinal leech, Hirudo medicinalis, is an excellent example of the use of invertebrates in the treatment of human disease. Utilized for various medical indications since the ancient times, the medicinal leech is currently being used in a narrow range of well-defined and scientifically-grounded clinical applications.

Why This Matters for Hirudotherapy

This review examined the current clinical applications of hirudotherapy using Hirudo medicinalis, focusing on its primary modern use in managing venous congestion associated with soft tissue replantations and free flap-based reconstructive surgery, along with indications, contraindications, practical handling, and therapy-related complications. The article is directly relevant to the American Society of Hirudotherapy's domain, as it consolidates practical clinical guidance on leech therapy drawn from searches of major medical databases and cross-referenced sources. As a review article, it synthesizes existing literature rather than presenting new experimental or clinical data, and its scope is limited to currently established clinical uses, which the authors note represent a narrow range of historically broader applications. Readers seeking primary outcome data, mechanistic studies of leech salivary components, or evidence on emerging indications will need to consult the underlying original research cited within the review.

Citation

Clinical uses of the medicinal leech: a practical review.

Porshinsky B et al. · Journal of postgraduate medicine, 2011

DOI

Added to ASH library: March 18, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.