American Society of Hirudotherapy

The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient

Case report published in Acta Chirurgiae Plasticae (2014)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsStreit L, Dvořák Z, Novák O, Stiborová S, Veselý J · Acta chirurgiae plasticae, 2014

Abstract

Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsAmputation, TraumaticAnimalsChild, PreschoolFinger InjuriesHumansLeechingMaleReplantation

Summary

Successful fingertip replantation in a 4-year-old without venous anastomosis using medicinal leeches as temporary venous drainage; only 48 hours of venous congestion and no transfusion required.

Why This Matters for Hirudotherapy

This case report describes a 4-year-old who underwent fingertip replantation without venous anastomosis, where medicinal leeches provided temporary venous drainage; the authors observed an unusually short period of venous congestion (48 hours) and no need for blood transfusion, accompanied by a literature review. It supports one of hirudotherapy's best-recognized roles in ASH's evidence picture, salvage of venous-congested replants and flaps where outflow cannot be surgically restored, here in a pediatric distal amputation. The caveat is that this is a single case report; the favorable course in one child cannot establish success rates or transfusion benefit, and it is reported as illustrative experience rather than comparative evidence.

Citation

The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

Streit L, Dvořák Z, Novák O, Stiborová S, Veselý J · Acta chirurgiae plasticae, 2014

Added to ASH library: May 26, 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.