The Relationship between Explanation and Patient Compliance in Hirudotherapy
Research article published in Archives of craniofacial surgery (2017)
Abstract
BACKGROUND: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. METHODS: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. RESULTS: Overall subjects' compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. CONCLUSION: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion.
Why This Matters for Hirudotherapy
This questionnaire-based study examined how providing patients and carers with explanations of hirudotherapy's benefits affected their willingness to accept leech therapy for flap congestion salvage, using a 0–10 compliance scale across demographic subgroups. This is directly relevant to ASH's domain, as psychological aversion to leeches is a well-recognized barrier to clinical hirudotherapy, and the finding that proper explanation improves acceptance has practical implications for patient education and therapeutic implementation. The study also observed higher compliance among younger individuals and those with medical backgrounds. However, the abstract provides limited quantitative detail—no sample size, effect sizes, or statistical results beyond directional statements—and the findings reflect reported attitudes rather than measured clinical outcomes of hirudotherapy itself.
Citation
The Relationship between Explanation and Patient Compliance in Hirudotherapy.
Kim K et al. · Archives of craniofacial surgery, 2017
Added to ASH library: March 18, 2026 · Site last updated: June 18, 2026