Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap
Randomized controlled trial published in Microsurgery (2010)
Abstract
INTRODUCTION: The originally described distally based sural flap technique has a risk of partial or total flap necrosis as high as 25%. The purpose of this study was to compare the medicinal leech therapy (MLT) with venous catheterization (VC) for blood volume removal, infection, wound dehiscence, and flap necrosis in the distally based sural flap with venous congestion. PATIENTS AND METHODS: Fifty-six conventional distally based sural flaps with venous congestion during reconstructive surgeries were randomly divided into two groups, MLT group and VC group. The results of comparisons were analyzed using SPSS software (SPSS for Windows Ver.11.5). RESULTS: There were significant differences in terms of the average volume of removed blood (53.6cc vs.172.2cc), infection (10.7% vs. 34.6%), wound dehiscence (10.7% vs. 42.3%), flap necrosis (3.6% vs. 19.2%), and nursing (7.8 vs. 5.19) and patient's satisfaction (8.03 vs. 5.6) in the VC group and MLT group, respectively. Although local heparin irrigation was performed in the VC group, the catheter was exchanged in 10 patients due to obstruction by clot. CONCLUSION: It is recommended that the VC be used for congested pedicled flaps instead of leech therapy, as VC is more effective, easy, and safe in blood removal, and it has less complication.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
RCT of 56 sural flaps with venous congestion comparing medicinal leech therapy versus venous catheterization. VC group showed less infection (10.7% vs 34.6%), wound dehiscence (10.7% vs 42.3%), and flap necrosis (3.6% vs 19.2%).
Why This Matters for Hirudotherapy
This study of 56 distally based sural flaps with venous congestion, randomly divided into two groups, compared medicinal leech therapy (MLT) with venous catheterization (VC) for blood removal volume, infection, wound dehiscence, and flap necrosis. The MLT group showed greater average blood removal (172.2cc vs. 53.6cc in the VC group) but higher infection (34.6% vs. 10.7%), wound dehiscence (42.3% vs. 10.7%), and flap necrosis rates (19.2% vs. 3.6%), with lower nursing and patient satisfaction scores; the authors concluded VC should replace leech therapy for congested pedicled flaps. For ASH, this is directly relevant as a controlled head-to-head
Citation
Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap.
Mozafari N et al. · Microsurgery, 2010
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