American Society of Hirudotherapy

Leech therapy and bleeding wound techniques to relieve venous congestion

Experimental study published in J Reconstr Microsurg (1990)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsSmoot EC et al. · Journal of reconstructive microsurgery, 1990

Abstract

Temporary restoration of capillary skin blood flow can be established by using leeches or by the creation of a dermal wound and the promotion of continued bleeding from the wound site in a flap with venous occlusion. An increasing restoration of capillary flow occurred with initial application of the leech and tended to exceed other techniques of restoring flow. However, all techniques of exsanguination, including leech therapy, restored very low perfusion over a two-hour course of therapy for a volume of tissue simulating a distal finger replant. The temporary increase in flap perfusion with a single leech application was greatest during the feeding activity of the leech and tapered off after the leech was satiated, to approximate flows achieved with local heparin injection and a punch wound.

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

Publication typeJournal Article
Indexed MeSH termsAnimalsBloodlettingCapillariesDermatologic Surgical ProceduresHeparinHumansLasersLeechesPuncturesRatsRats, Inbred StrainsRegional Blood Flow

Summary

Compares leech application to creation of bleeding dermal wound for restoring capillary skin flow in flaps with venous occlusion. Leech feeding produced the greatest temporary perfusion improvement.

Why This Matters for Hirudotherapy

This study compares techniques for relieving venous congestion — including leech therapy, dermal wounding, and local heparin injection — in a tissue model simulating a flap with venous occlusion, measuring capillary blood flow restoration over a two-hour period. Leech application produced the greatest initial increase in flap perfusion during active feeding, but perfusion tapered after satiation and ultimately approximated flows achieved by heparin injection and punch wounding; all techniques restored only very low perfusion levels. This is directly relevant to ASH's domain as an experimental evaluation of leeching for venous congestion relief. However, the abstract does not specify the species used, and findings suggest modest, temporary perfusion restoration rather than robust clinical efficacy.

Citation

Leech therapy and bleeding wound techniques to relieve venous congestion.

Smoot EC et al. · Journal of reconstructive microsurgery, 1990

DOI

Added to ASH library: May 27, 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.