American Society of Hirudotherapy

The use of medicinal leeches in microsurgery

Clinical review published in Blood Coagulation & Fibrinolysis (1991)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical LiteratureValauri FA · Blood coagulation & fibrinolysis, 1991

Abstract

Medicinal leeches have been used to treat a variety of ailments for thousands of years. During the past decade the leech has become valuable for salvaging surgically uncorrectable venous insufficiency which is occasionally encountered after microsurgical free flap and replantation procedures. Leech anatomy and physiology are reviewed. Indications and the technique for application of medicinal leeches is discussed, as well as potential complications of leeching.

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

Publication typeHistorical ArticleJournal ArticleReview
Indexed MeSH termsAmputation, TraumaticAnimalsBloodlettingEarFinger InjuriesHistory, 18th CenturyHistory, 19th CenturyHistory, 20th CenturyHistory, AncientHumansLeechesMicrosurgeryReplantationSurgical Flaps

Summary

This review summarizes medicinal leech anatomy, physiology, indications and application technique, emphasizing the leech's value for salvaging surgically uncorrectable venous insufficiency after microsurgical free flap and replantation procedures.

Why This Matters for Hirudotherapy

This review recounts the long history of medicinal leech use for treating various ailments over thousands of years and focuses on their contemporary value for salvaging surgically uncorrectable venous insufficiency occasionally encountered after microsurgical free flap and replantation procedures. Leech anatomy and physiology are reviewed, along with indications, the technique for application of medicinal leeches, and potential complications of leeching. This serves as an overview of live-leech hirudotherapy in a defined clinical context. Caveat: this is a historical review without original study data, controls, or quantitative outcomes; the clinical claims reflect practice description rather than evidence from trials.

Citation

Reference (Vancouver style)

Valauri FA. The use of medicinal leeches in microsurgery. Blood Coagul Fibrinolysis. 1991;2(1):185-187. doi:10.1097/00001721-199102000-00028. PMID: 1772989

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

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.