Leech Therapy For The Treatment Of Venous Congestion In Flaps, Digital Re-Plants And Revascularizations - A Two-Year Review From A Regional Centre
Retrospective study published in J Ayub Med Coll Abbottabad (2016)
Abstract
BACKGROUND: Leeches are a well-recognized treatment for congested tissue. This study reviewed the efficacy of leech therapy for salvage of venous congested flaps and congested replanted or revascularized hand digits over a 2-year period. METHODS: All patients treated with leeches between 1 Oct 2010 and 30 Sep 2012 (two years) at Queen Elizabeth Hospital, Birmingham, UK were included in the study. Details regarding mode of injury requiring reconstruction, surgical procedure, leech therapy duration, subsequent surgery requirement and tissue salvage rates were recorded. RESULTS: Twenty tissues in 18 patients required leeches for tissue congestion over 2 years: 13 men and 5 women. The mean patient age was 41 years (range 17-79). The defect requiring reconstruction was trauma in 16 cases, following tumour resection in two, and two miscellaneous causes. Thirteen cases had flap reconstruction and seven digits in six patients had hand digit replantations or revascularisation. Thirteen of 20 cases (65%) had successful tissue salvage following leech therapy for congestion (77% in 10 out of 13 flaps, and 43% in 3 of 7 digits). The rate of tissue salvage in pedicled flaps was good 6/6 (100%) and so was in digital revascularizations 2/3 (67%), but poor in digital re-plants 1/4 (25%) and free flaps 0/2 (0%). CONCLUSIONS: Leeches are a helpful tool for congested tissue salvage and in this study, showed a greater survival benefit for pedicled flaps than for free flaps or digital replantations.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Two-year regional review of leech therapy in 18 patients (20 tissues): 65% successful tissue salvage with 100% success in pedicled flaps, 67% in digital revascularizations, 25% in replants and 0% in free flaps.
Why This Matters for Hirudotherapy
This two-year retrospective review from a single regional center assessed leech therapy for venous congested flaps and digits in 18 patients (20 tissues), reporting an overall salvage rate of 65% (77% in flaps, 43% in digits), with good results in pedicled flaps (100%) and digital revascularizations (67%) but poor outcomes in digital replants (25%) and free flaps (0%). For ASH, this is relevant as real-world clinical outcome data on hirudotherapy across reconstructive indications. Honest caveat: this is a retrospective, uncontrolled single-center series with a small sample (18 patients), no comparator group, and wide variation in salvage rates across tissue types; results are observational and may not generalize.
Citation
Leech Therapy For The Treatment Of Venous Congestion In Flaps, Digital Re-Plants And Revascularizations - A Two-Year Review From A Regional Centre.
Butt AM et al. · Journal of Ayub Medical College, Abbottabad, 2016
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