Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia/Reperfusion Injury: Benefits, Complications, and Contradictions
Review published in Arch Bone Jt Surg (2022)
Abstract
The use of free cutaneous or myocutaneous flaps in some surgeries, especially in reconstructive surgeries, is routine and imperative; nevertheless, it is controversial because of fear of flap loss due to tissue congestion and partial or complete necrosis. Different mechanisms are discussed in this process, and based on the involved mechanisms, various agents and approaches are suggested for flap salvage. Among these agents and strategies, leech therapy (hirudotherapy) can be a valuable complementary treatment; however, in this way, full attention should be given to all beneficial and harmful aspects to reach the best results. This study included a literature review of the essential complications following free tissue transfer and explained the effects of leech therapy for the respective complications. Based on the review of the literature, the essential complications following free tissue transfer were (I) venous obstruction and congestion, (II) delay in blood flow reestablishment, (III) ischemia/reperfusion injuries, and (IV) thrombus formation. Leech therapy can protect free flaps against the mentioned complications as a complementary treatment. Leech therapy is an appropriate complement, however, not a definite approach for flap salvage. Therefore, in some patients, other alternative methods or even flap removal may be a better option.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Reviews leech therapy benefits in free flap complications including venous obstruction, ischemia/reperfusion injury and thrombus formation, with cautions on patient selection.
Por qué esto importa para la hirudoterapia
This review discussed leech therapy (hirudotherapy) as a complementary measure to protect free flaps against venous congestion, delayed reestablishment of blood flow, ischemia/reperfusion injury, and thrombus formation following reconstructive surgery, concluding it is a useful adjunct but not a definitive flap-salvage approach. For ASH, this is relevant as a synthesis of mechanisms and clinical rationale for hirudotherapy in a major established surgical indication. Honest caveat: no Publication types or MeSH are provided and the abstract indicates a literature review rather than original data; claims are narrative, no quantitative effect sizes are given, and the authors explicitly note that in some patients alternative methods or flap removal may be preferable.
Citación
Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia/Reperfusion Injury: Benefits, Complications, and Contradictions.
Mousavian A et al. · The archives of bone and joint surgery, 2022
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026