Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique
Cohort study published in ORL; journal for oto-rhino-laryngology and its related specialties (2022)
Abstract
Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort. Several protocols recommend blocking the path to the oropharynx via gauze or leaving a tracheotomy in place to protect the airway. This report pre-sents a novel technique for intraoral hirudotherapy that is safe and simple for treatment of free flap venous congestion. The base of a clear cup or a plastic lid is utilized, and the leech is attached onto the inside of the lid with 2 sutures near each end. Several cups with leeches attached are made at a time to reduce delay and difficulty of application by less experienced clinical staff. The leech is then applied onto the compromised flap and then simply removed once it has unlatched from the flap. This method allows the leech to be applied with ease by multiple members of the healthcare team, decreases the need for intraoral manipulation, and reduces the risk of migration into the aerodigestive tract. Future prospective studies are warranted to assess the efficacy of this technique.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort.
Por qué esto importa para la hirudoterapia
Este informe describe una técnica novedosa para administrar hirudoterapia intraoral con el fin de manejar la congestión venosa tras la reconstrucción con colgajo libre de cabeza y cuello, en la cual una sanguijuela se sutura dentro de un vaso transparente o una tapa de plástico y luego se aplica sobre el colgajo comprometido. Este trabajo es directamente relevante para la práctica de la hirudoterapia, ya que aborda barreras bien reconocidas para el uso intraoral de sanguijuelas —incluyendo los riesgos de migración a la vía aérea, infección por manipulación repetida y dificultad de aplicación para el personal con menos experiencia— mediante la propuesta de un enfoque estandarizado y basado en dispositivos preensamblados. Para el ámbito de ASH, el estudio ilustra soluciones prácticas de ingeniería y de flujo de trabajo que pueden mejorar el perfil de seguridad y la adopción clínica de la terapia con sanguijuelas en entornos reconstructivos complejos. Sin embargo, el resumen presenta solo una descripción técnica sin datos cuantitativos de resultados, resultados de pacientes ni análisis comparativo, y los propios autores señalan que se justifican estudios prospectivos para evaluar la eficacia, por lo que el beneficio clínico de esta técnica sigue sin demostrarse.
Citación
Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique.
Amanian A et al. · ORL; journal for oto-rhino-laryngology and its related specialties, 2022
Contexto clínico relacionado
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Añadido a la biblioteca ASH: March 18, 2026 · Última actualización del sitio: June 18, 2026