American Society of Hirudotherapy

The return of the leech

Review published in International journal of clinical practice (2003)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical LiteratureAbdelgabar A, Bhowmick B · International journal of clinical practice, 2003

Abstract

Medicinal leeches (Hirudo medicinalis) have been used in medicine for thousands of years to treat a wide range of ailments. Nowadays, leeches are used successfully for only a few conditions, notably in the field of reconstructive or microsurgery, to salvage tissue flaps and skin grafts whose viability is threatened by venous congestion. The anticoagulant properties of hirudin, contained in leech saliva, may lead to wider therapeutic applications in the prevention and treatment of thromboembolic disease. Optimal care is needed when applying leeches, because their use can be complicated by serious bacterial infections.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAnimalsForecastingHirudin TherapyHumansLeechesLeechingSalvage TherapySepsisThromboembolism

Summary

This review outlines the modern reintroduction of Hirudo medicinalis in reconstructive and microsurgery for venous congestion and flap salvage, while noting infection complications and potential wider applications of leech-derived hirudin in thromboembolic disease.

Why This Matters for Hirudotherapy

This article discusses the historical and contemporary medical use of medicinal leeches (Hirudo medicinalis), noting their established role in reconstructive and microsurgery to salvage tissue flaps and skin grafts threatened by venous congestion. It identifies hirudin, an anticoagulant found in leech saliva, as a substance that may have wider therapeutic applications in thromboembolic disease prevention and treatment, and cautions that leech application carries a risk of serious bacterial infections. However, the broader therapeutic possibilities described for hirudin are presented as prospective rather than demonstrated, and the article offers general discussion without specific clinical or experimental findings to support its forward-looking projections.

Citation

Reference (Vancouver style)

Abdelgabar AM, Bhowmick BK. The return of the leech. Int J Clin Pract. 2003;57(2):103-105. PMID: 12661792

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

PubMed

Added to ASH library: March 18, 2026 · Site last updated: November 1, 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.