Medicinal leech therapy on head and neck patients: a review of literature and proposed protocol

OBJECTIVES: To this day, a standardized protocol for medicinal leech therapy does not exist. The purpose of this article was to review literature in the hope of proposing a unified, coherent, feasible, and safe protocol for using medicinal leeches when warranted. STUDY DESIGN: A literature search was conducted in the following databases: PubMed, MDConsult, The Cochrane Library, OMIM, and Google. This was supplemented by a search for selected authors. Keywords used were medicinal leech therapy, leech therapy, leeching, replantation, thromboembolism, venous congestion, Hirudo medicinalis, Hirudotherapy, leech protocol, and Hirudo protocol. RESULTS: Based on titles and abstracts, 26 articles and 1 Web site were identified. CONCLUSIONS: Leech therapy can be an excellent alternative for the treatment of venous congestion in free flaps, pedicled flaps, and replanted tissues. Psychological precounseling, antibiotic therapy, number of leeches to be used, length of therapy, and laboratory checks should be taken into consideration before initiating therapy.

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

To this day, a standardized protocol for medicinal leech therapy does not exist. The purpose of this article was to review literature in the hope of proposing a unified, coherent, feasible, and safe protocol for using medicinal leeches when warranted.

Explore how this research connects to clinical practice

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)