Leech management before application on patient: a nationwide survey of practices in French university hospitals
Research article published in Antimicrobial resistance and infection control (2018)
Abstract
BACKGROUND: Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. METHODS: Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. RESULTS: Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%), but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2), sulfamethoxazole/trimethoprim (2) or amoxicillin/clavulanic acid (1). CONCLUSIONS: Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%.
Why This Matters for Hirudotherapy
This nationwide survey examined leech management practices—storage, external decontamination, microbiological controls, delivery traceability, and antibiotic prophylaxis—across French university hospitals using leech therapy in plastic and reconstructive microsurgery. The findings are directly relevant to hirudotherapy, highlighting significant variability in infection-prevention protocols and low rates of systematic antibiotic prophylaxis, external decontamination, and batch traceability, all of which bear on patient safety and salvage outcomes. The authors call for standardized good-practice guidelines to reduce infectious complications, which remain a major clinical risk that can reduce flap salvage rates substantially. The study is limited to self-reported practices from French centers and does not test or compare interventions, so it characterizes current practice gaps rather than establishing optimal protocols or demonstrating efficacy of any particular management approach.
Citation
Leech management before application on patient: a nationwide survey of practices in French university hospitals.
Grau D et al. · Antimicrobial resistance and infection control, 2018
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