Medicinal Leech Therapy: Friend or Foe

Leech therapy is the ancient practice of bloodletting or bloodsucking and is considered one of the oldest medical practices known. Its use has spanned centuries and is still used in plastic surgery practices today when performing free flaps and replants. The purpose of this article is to discuss the history of this ancient therapy and to describe the leech and its present indications, complications, contraindications, and techniques.

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

Leech therapy is the ancient practice of bloodletting or bloodsucking and is considered one of the oldest medical practices known. Its use has spanned centuries and is still used in plastic surgery practices today when performing free flaps and replants.

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More peer-reviewed studies in Clinical Trials.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Institutional Outcomes in Leech-Assisted Microsurgery — 87 Patients — Cornejo A et al. (2017)
• Leech Therapy for Knee OA — Confirmatory RCT — Andereya S et al. (2008)
• Leech Therapy for OA — Systematic Review and Meta-Analysis — Lauche R et al. (2014)
• Leech Therapy for Thumb Osteoarthritis — RCT — Michalsen A et al. (2008)
• BRIGHT-4 Trial — Bivalirudin vs Heparin by BMI — BRIGHT-4 Investigators (2025)
• Aeromonas hydrophila Infections Following Leech Use in Flap Surgery — Lineaweaver WC et al. (1992)
• Leech Therapy for Lateral Epicondylitis — RCT — Michalsen A et al. (2014)
• Leech Therapy in Flap Salvage — Timing and Practical Recommendations — Herlin C et al. (2017)