William C. Lineaweaver

Importancia para la hirudoterapia

William C. Lineaweaver is an American surgeon whose clinical work in microsurgical units addressed the complications of medicinal leech therapy. In 1991 he and colleagues at the Microsurgical Replantation-Transplantation Department of Davies Medical Center, San Francisco, surveyed the unit's experience of leech application to 67 patients, presenting five illustrative cases to explain strategies of leech use (PMID 1772990). Building on this experience, he examined Aeromonas hydrophila infection, a recognised complication of postoperative leech application, reviewing 11 previously reported leech-related infections and analysing seven unreported cases that ranged from minor wound complications to extensive tissue loss and sepsis (PMID 1524373). These infections often followed leech application to tissue with questionable arterial perfusion, with clinical onset ranging from within 24 hours to 10 days or more after application; late infections may represent bacterial invasion from colonised necrotic tissue. He recommended restricting leeches to tissue with arterial perfusion, administering antibiotics effective against Aeromonas hydrophila before application, and considering oral therapy until wound closure for patients discharged with eschars or open wounds (PMID 1524373). In 2020, at the JMS Burn and Reconstruction Center in Jackson, Mississippi, he co-authored (with Mokhtar and colleagues) a report of three consecutive finger-replantation patients whose Aeromonas isolates were resistant to ciprofloxacin and sensitive to cefepime, prompting the unit to adopt cefepime for routine coverage and to recommend ongoing monitoring of resistance (PMID 31556841).