Acute postoperative infection with Aeromonas hydrophila after using medical leeches for treatment of venous congestion
Case series published in Archives of Orthopaedic and Trauma Surgery (2010)
Abstract
INTRODUCTION: Venous convulsion after reconstructive microsurgery procedures is one major complication a surgeon has to deal with. Today, especially in the field of reconstructive microsurgery, medicinal leech therapy enjoys a renaissance. The potential risks such as infections associated with leech therapy are generally underestimated and not sufficiently discussed in literature. METHOD/PATIENTS: We present five male patients with an average age of 47 years. All patients suffered from a trauma incident, which had to be treated as an emergency. Three patients showed, postoperatively, a venous congestion after the reconstructive procedures. Another two patients with flap reconstruction and flap training developed venous problems after 12 and 14 days. In all five cases, the indication was given to use medical leeches (Hirudo medicinalis). In all the patients, a local infection of the injured extremity could be regarded after beginning with the leech treatment. The treatment duration with medical leeches for postoperative venous congestion was an average of 6 days. RESULTS: The reconstructive procedures in all five cases were unfortunately unsuccessful as major local infections were observed. Microbiological analyses showed, in all cases, an infection with Aeromonas hydrophila. CONCLUSION: We recommend making a considered indication for leech therapy, to diagnose wound infections early and to think about prophylactic antibiotics in patients with leech application.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Five patients receiving leech therapy after reconstructive microsurgery developed Aeromonas hydrophila infections leading to flap failure, underscoring the importance of antibiotic prophylaxis and early infection diagnosis.
Por qué esto importa para la hirudoterapia
Este informe describe cinco pacientes varones traumatológicos que desarrollaron infecciones locales por Aeromonas hydrophila tras terapia con sanguijuela medicinal (Hirudo medicinalis) para la congestión venosa posoperatoria después de procedimientos de microcirugía reconstructiva. Los hallazgos son directamente relevantes para la práctica de la hirudoterapia, ya que los cinco procedimientos reconstructivos no tuvieron éxito debido a infecciones locales importantes, lo que llevó a los autores a recomendar una indicación cuidadosa de la terapia con sanguijuelas, el diagnóstico temprano de infecciones de la herida y la consideración de antibióticos profilácticos cuando se aplican sanguijuelas. Sin embargo, el informe involucra solo cinco pacientes y el resumen proporciona un detalle limitado sobre la metodología microbiológica, sobre si se utilizó profilaxis antibiótica inicialmente, o sobre las tasas comparativas de infección, lo que restringe conclusiones más amplias acerca de la magnitud del riesgo de infección o de las estrategias óptimas de prevención.
Citación
Acute postoperative infection with Aeromonas hydrophila after using medical leeches for treatment of venous congestion.
Schnabl SM, Kunz C, Unglaub F et al. · Archives of orthopaedic and trauma surgery, 2010
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026