Salvage of partial facial soft tissue avulsions with medicinal leeches
Case series published in Otolaryngol Head Neck Surg (2004)
Abstract
BACKGROUND: Medicinal leeches have been demonstrated to be extremely useful and safe in the salvage of venous outflow compromised tissue, particularly in digit replants and various forms of flaps. OBJECTIVE: To demonstrate the utility of medicinal leeches in the salvage of venous outflow-compromised traumatic soft tissue avulsions in key facial structures. METHODS: A retrospective review of 4 cases involving the external ear, nose, lip, and scalp in which apparent venous outflow compromise was present. Medicinal leeches were applied acutely in each of these 4 cases, salvaging each of the partially avulsed soft tissue segments. RESULTS: Complete or near complete salvage of each soft tissue segment after using medicinal leeches. CONCLUSIONS: Although it is unusual for a partial soft tissue avulsion of the face to require medicinal leech therapy, situations may occur in which there is adequate arterial inflow but inadequate venous outflow. In such cases, medicinal leeches may play a very important role in salvaging the soft tissue segment. This is particularly important in vital structures such as the ear, nose, lip, and eyelid in which acute or secondary reconstruction is complex. EBM RATING: C.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Four cases of traumatic soft-tissue avulsion of the ear, nose, lip, and scalp treated successfully with acute application of medicinal leeches to salvage venous-compromised segments.
Why This Matters for Hirudotherapy
This case report series examined the use of medicinal leeches to salvage four cases of partial facial soft tissue avulsions (involving the ear, nose, lip, and scalp) suffering from venous outflow compromise. The findings demonstrate the practical utility of hirudotherapy in managing acute venous congestion in complex facial structures, resulting in complete or near-complete tissue salvage. For the American Society of Hirudotherapy, this provides direct clinical evidence supporting the use of medicinal leeches in specialized reconstructive and trauma settings. However, the evidence is limited to a small, retrospective case series of four patients without a control group.
Citation
Salvage of partial facial soft tissue avulsions with medicinal leeches.
Frodel JL, Barth P, Wagner J · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2004
Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026