Use of the medicinal leech for salvage of venous congested microvascular free flaps of the head and neck

OBJECTIVE: The objective of the study was to determine the utility of leech therapy in venous congested microvascular free flaps in which venous outflow could not be established or surgical revision was unsuccessful. METHODS: We conducted a retrospective review of all patients at a tertiary referral center from January 2002 to December 2008 who received leech therapy for a venous congested microvascular free flap in which venous outflow could not be established primarily or failed surgical revision. RESULTS: Six patients were identified. Leech therapy was required for a median of 9 days (4-14 days). The median lowest hemoglobin level per patient was 8.0 g/dL (5.4-9.3 g/dL). All patients (6/6, 100%) required blood transfusions during therapy. The median number of units of packed red blood cells transfused per patient was 13.5 U (4-29 U). All flaps (6/6, 100%) were successfully salvaged with leech therapy. There was one minor complication, observed as 2 episodes of syncope in the same patient, related to anemia. There were no cases of infection transmitted as a result of leech therapy. CONCLUSIONS: Leech therapy can be used to successfully salvage venous congested microvascular free flaps in the absence of primary venous outflow. Leech therapy can be used safely and with little morbidity compared with other reports.

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

Six patients with venous-congested microvascular head and neck free flaps treated with leech therapy: 100% flap salvage. All 6 required blood transfusion (median 13.5 units); no documented infection transmissions.

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)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →