Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review
Systematic review published in World journal of plastic surgery (2024)
Abstract
BACKGROUND: We aimed to assess the effect of hirudotherapy on flap congestion and thrombosis in adult female patients who underwent microvascular breast reconstruction. METHODS: A systematic review of PubMed, Web of Science, and Cochrane was completed. A qualitative synthesis of all included studies was then performed. RESULTS: Twelve studies were included, pooling 34 female patients with ages ranging from 28 to 64 years old, having received medical leech therapy to breast flap following microsurgical breast reconstruction for a duration ranging from 1 to 10 days. The most common flap in our patient population was the Transverse Abdominis (TRAM) flap, followed by the Deep Inferior Epigastric (DIEP) flap and lastly, the Latissimus Dorsi flap. Nine patients experienced flap loss (26.5%), 9 experienced infections (26.5%), 19 had some degree of flap necrosis (55.9%), and 8 patients had to return to the operating room for revision surgeries (23.5%). Of the 9 reported cases of infection, 6 grew cultures specific to leech pathogens, confirming hirudotherapy as the cause (17.6%). CONCLUSION: Presently, this systematic review provides an overview of the role that hirudotherapy has played in the management of congestion in breast microvascular reconstruction in the literature. Clinicians should be aware of the complications associated with this choice of therapy for their patients, especially infection. Despite their established use in flap congestion, the limited evidence available for hirudotherapy to treat flap complications in autologous breast reconstruction calls for more studies to be conducted on the matter.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
We aimed to assess the effect of hirudotherapy on flap congestion and thrombosis in adult female patients who underwent microvascular breast reconstruction.
Por qué esto importa para la hirudoterapia
Esta revisión sistemática evaluó el uso de la terapia con sanguijuelas medicinales para la congestión del colgajo y la trombosis tras la reconstrucción mamaria microvascular, agrupando doce estudios con un total de 34 pacientes de sexo femenino que recibieron terapia con sanguijuelas en colgajos TRAM, DIEP o Latissimus Dorsi durante períodos de 1 a 10 días. Los hallazgos son directamente pertinentes para la práctica de la hirudoterapia, ya que los autores informan tasas de resultados y complicaciones —incluida la pérdida del colgajo (26,5 %), la necrosis del colgajo (55,9 %), la infección (26,5 %, con un 17,6 % confirmada como asociada a patógenos de la sanguijuela) y el regreso al quirófano (23,5 %)—, destacando tanto el papel terapéutico como el riesgo de infección de las sanguijuelas medicinales en una indicación clínica bien establecida. Como salvedad, esta revisión sistemática sintetiza una cohorte agrupada pequeña de solo 34 pacientes a partir de estudios fuente heterogéneos, y los autores señalan explícitamente la evidencia disponible limitada y solicitan más investigación; las tasas de complicaciones, por lo tanto, deben interpretarse con cautela y podrían no generalizarse ampliamente.
Citación
Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review.
Foppiani J et al. · World journal of plastic surgery, 2024
Contexto clínico relacionado
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Añadido a la biblioteca ASH: March 18, 2026 · Última actualización del sitio: June 18, 2026