Quantitative analysis of hemodynamics of congested island flaps under leech therapy
Research article published in The journal of medical investigation : JMI (2013)
Abstract
BACKGROUND: A congested flap is a good indication for leech therapy. However, determining the appropriate number of leeches as well as the appropriate application time in clinical cases is difficult. We analyzed hemodynamics in rabbit island flaps under leech therapy to find a suitable clinical procedure for determining the appropriate number of leeches to be used and the duration of therapy. METHODS: Island flaps were raised in 35 rabbit ears, and congestion was induced by venous clamping. Treatment involved use of 1 or 3 leeches and was begun 60 minutes after venous occlusion. Flaps were examined for area of surviving tissue, alterations in transcutaneous oxygen and carbon dioxide tension (TcPO2 and TcPCO2), and flow volume. Arteriole and venule diameters and flow velocities were examined microscopically. RESULTS: Flap survival area in the 3-leech therapy group was significantly larger than the 1-leech therapy group and the control group. With 3-leech therapy, TcPCO2 decreased significantly, as did arteriole and venule diameters. After clamp release, TcPCO2 and venule diameter continued to decrease in this group, and flow velocity increased significantly. CONCLUSIONS: Leech therapy may salvage compromised flaps by replacing congested blood with new arterial blood and thus maintaining flap viability. TcPO2 and TcPCO2 monitoring may help evaluate the therapeutic effect and determine the appropriate number of leeches to apply and the duration of therapy.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
A congested flap is a good indication for leech therapy.
Por qué esto importa para la hirudoterapia
Este estudio experimental examinó la hemodinámica en 35 colgajos en isla de oreja de conejo con congestión inducida por pinzamiento venoso, tratados con 1 o 3 sanguijuelas a partir de los 60 minutos posteriores a la oclusión. El grupo de 3 sanguijuelas alcanzó un área de supervivencia del colgajo significativamente mayor que el grupo de 1 sanguijuela y los controles; dentro del grupo de 3 sanguijuelas, la TcPCO2 y los diámetros de arteriolas/vénulas disminuyeron significativamente, y tras la liberación del pinzamiento estas tendencias continuaron mientras la velocidad de flujo aumentó. Estos hallazgos son directamente relevantes para la hirudoterapia, al proporcionar evidencia preclínica de que la cantidad de sanguijuelas afecta los resultados de salvamento y sugerir que la monitorización transcutánea de gases podría ayudar a los clínicos a determinar el número apropiado de sanguijuelas y la duración del tratamiento, cuestiones prácticas clave para el uso de sanguijuelas medicinales en cirugía reconstructiva. La principal salvedad es que se trata de un modelo animal de oclusión venosa aguda inducida quirúrgicamente, que podría no representar plenamente la complejidad de la congestión clínica de colgajos en humanos.
Citación
Quantitative analysis of hemodynamics of congested island flaps under leech therapy
Kashiwagi K et al. · The journal of medical investigation : JMI, 2013
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026