Use of the mechanical leech for successful zone I replantation
Case series published in TheScientificWorldJournal (2014)
Abstract
Replantation of zone I finger injuries remains a challenge, particularly if the fingertip was previously scarred or atrophied, which makes it difficult to secure a suitable vein at the amputation site. In cases of artery-only anastomosis, we propose using a mechanical leech technique to maintain sufficient venous outflow until the internal circulation regenerates. We applied this procedure to eight patients who had zone 1 amputations without veins that were suitable for anastomosis. Emergent surgery was performed and an artery-only anastomosis was created. As there were no veins available, we cut a branch of the central artery and anastomosed it with a 24-gauge angioneedle, which served as a conduit for venous drainage. The overall survival rate for zone I replantation using mechanical leech was 87.5% and the average time to maintain the mechanical leech was 5 days. The mechanical leech technique may serve as an alternative option for the management of venous congestion when no viable veins are available.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Eight patients with zone I fingertip amputations underwent artery-only replantation with a 24-gauge angioneedle serving as a venous-drainage conduit. Overall survival was 87.5% with a mean 5 days of mechanical leech use.
Why This Matters for Hirudotherapy
This study describes a 'mechanical leech' technique used in 8 patients with zone I finger amputations where no suitable veins were available for anastomosis. The technique involved creating an artery-only anastomosis and using a 24-gauge angioneedle connected to a branch of the central artery as a conduit for venous drainage, maintained for an average of 5 days. The reported overall survival rate was 87.5%. For ASH, this is conceptually but not directly relevant—the term 'mechanical leech' refers to a surgical device designed to replicate the venous-decongestion function of medicinal leeches, but no actual leeches or leech-derived substances were used. The relevance to ASH is limited to the shared therapeutic goal of managing venous congestion, and the study does not involve hirudotherapy or the leech secretome.
Citation
Use of the mechanical leech for successful zone I replantation.
Kim SW, Han HH, Jung SN · TheScientificWorldJournal, 2014
Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026