American Society of Hirudotherapy

Leech Therapy in Flap Salvage — Timing and Practical Recommendations

Systematic review establishing timing of leech application as the dominant prognostic factor

Last Updated: March 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Clinical TrialsSafety & Infection ControlHerlin C et al. · Journal of Plastic, Reconstructive & Aesthetic Surgery, 2017

Summary

Systematic review of leech therapy for flap salvage with practical clinical recommendations. Identified timing of leech application as the single most important prognostic factor: early application (within 6 hours of congestion onset) significantly improved salvage rates compared to delayed treatment.

Why This Matters for Hirudotherapy

Translates research evidence into actionable clinical guidance. The finding that timing is the dominant variable has directly shaped institutional protocols, emphasizing the need for immediate leech availability in microsurgery units and round-the-clock monitoring for venous congestion signs.

Citation

Leech Therapy in Flap Salvage: Systematic Review and Practical Recommendations

Herlin C et al. · Journal of Plastic, Reconstructive & Aesthetic Surgery, 2017

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

Leech Therapy in Flap Salvage — Timing and Practical Recommendations | ASH