American Society of Hirudotherapy

The use of medicinal leeches, Hirudo medicinalis, to restore venous circulation in trauma and reconstructive microsurgery

Clinical series published in International Angiology (1994)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsSoucacos PN, Beris AE, Malizos KN et al. · International angiology, 1994

Abstract

Following replantation of complete or incomplete nonviable amputations of digits and hands, as well as microsurgical free tissue transfer, there is often a critical need for adjuvant therapy in order to restore sufficient venous drainage. In 24 out of 29 patients, venous insufficiency was successfully treated with the use of medicinal leeches. In a group of patients who had undergone replantation procedures (11 patients total), 9 patients (8 with digit and 1 with hand amputations) had venous drainage successfully restored with medicinal leeches, while in a group of patients who had free tissue transfers (18 patients total), 15 had the venous congestion treated successfully with leeches. The results indicate that medicinal leeches are a valuable, alternative method for the treatment of venous congestion in both replantation patients and those who have undergone free tissue transfer.

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

Publication typeJournal Article
Indexed MeSH termsAdolescentAdultAgedAmputation, TraumaticAnimalsChildFemaleFinger InjuriesHand InjuriesHumansLeechesMale

Summary

In 24 of 29 patients, venous insufficiency after replantation of digits/hands or microsurgical free tissue transfer was successfully treated with medicinal leeches, demonstrating leech therapy as a valuable alternative to surgical revision of venous outflow.

Why This Matters for Hirudotherapy

This study examined the use of medicinal leeches as adjuvant therapy for venous insufficiency following digit and hand replantation and microsurgical free tissue transfer, reporting successful restoration of venous drainage in 24 of 29 patients — 9 of 11 replantation patients and 15 of 18 free tissue transfer patients. These findings are directly relevant to hirudotherapy, providing clinical outcome data for one of the most established applications of medicinal leeches in managing postoperative venous congestion. This study sits squarely within ASH's core domain of medicinal leech therapy. However, the abstract provides only summary success rates without detail on treatment protocols, complications, infection management, or longer-term outcomes, and does not investigate the biological mechanisms underlying the observed clinical effects.

Citation

The use of medicinal leeches, Hirudo medicinalis, to restore venous circulation in trauma and reconstructive microsurgery.

Soucacos PN, Beris AE, Malizos KN et al. · International angiology, 1994

DOIPubMed

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.