American Society of Hirudotherapy

Salvage of venous congestion using medicinal leeches for traumatic nasal flap

Case report published in J Maxillofac Oral Surg (2013)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsJose M, Varghese J, Babu A · Journal of maxillofacial and oral surgery, 2013

Abstract

Medicinal leeches are extremely useful and safe in the salvage of venous outflow compromised tissue, particularly in digit replants and various forms of flaps. 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. We report a case of a 34-year-old gentleman who showed signs of venous congestion following primary management for a traumatic nasal flap. Successful salvage of venous congestion was done using medicinal leech therapy, once daily, for 5 days. His recovery deemed satisfactory and uncomplicated. Medicinal leeches are well-known in the treatment of venous congestion or complete venous outflow obstruction in larger pedicled flaps and microvascular transfers. In trauma, it is well established that medicinal leeches are invaluable in treating venous congestion in digit replants and replantation of totally avulsed external ear segments. A limited number of other reports have demonstrated the use of medicinal leeches for salvage of other partially avulsed facial structures. Medicinal leeches have a significant role in the management of traumatic and microvascular flaps, the oral and maxillofacial surgeon should weigh the benefits of such treatment before instituting other expensive or complex treatment modalities.

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

Publication typeCase ReportsJournal Article

Summary

Traumatic nasal flap with venous congestion in a 34-year-old man treated successfully with one-leech-daily MLT for 5 days, with uncomplicated recovery — extends MLT applications to partial soft-tissue facial avulsions.

Why This Matters for Hirudotherapy

This case report describes a 34-year-old man who developed venous congestion following primary management of a traumatic nasal flap and was successfully treated with medicinal leech therapy once daily for five days, with satisfactory and uncomplicated recovery. The authors note that while leeches are well-established for venous congestion in digit replants and larger flaps, only limited reports exist for partially avulsed facial structures. The report is directly relevant to ASH's domain as it documents hirudotherapy for an uncommon indication — traumatic nasal flap salvage — and suggests leeches may offer a simpler alternative to more complex treatment modalities. However, this is a single case report with no control group, so no generalizable efficacy conclusions can be drawn.

Citation

Salvage of venous congestion using medicinal leeches for traumatic nasal flap.

Jose M, Varghese J, Babu A · Journal of maxillofacial and oral surgery, 2013

Added to ASH library: May 26, 2026 · Site last updated: June 18, 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.