American Society of Hirudotherapy

Leech therapy and bleeding wound techniques to relieve venous congestion

Research article published in Journal of reconstructive microsurgery (1990)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsSmoot E 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

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.

Why This Matters for Hirudotherapy

This study directly compared leech therapy against alternative bleeding-wound techniques (local heparin injection, dermal punch wound) for restoring capillary blood flow in tissue subjected to venous occlusion, modeling a volume simulating a distal finger replant. The findings are of central relevance to ASH because they provide perfusion data showing that leech feeding produced the greatest initial flow restoration during active feeding, after which perfusion tapered to levels comparable to the other methods. This temporal profile has practical implications for understanding and optimizing leech therapy in venous-congestion settings. An important caveat is that all techniques achieved only very low perfusion over the two-hour course, and the abstract reports no data on flap survival, infection, longer-term outcomes, or comparative clinical efficacy beyond the immediate perfusion measurements.

Citation

Leech therapy and bleeding wound techniques to relieve venous congestion.

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

DOI

Added to ASH library: March 18, 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.