A Case of Medical Leech Therapy for Venous Congestion Following Forearm Flap Reconstruction
Case report published in Gan To Kagaku Ryoho (2018)
Abstract
Leeches have been used for medical treatment for at least 2,500 years. Plastic surgeons have recently begun to use leeches to reduce venous congestion after flap reconstruction. However, few reports of leech use in the oral region have been published. We report a case of medical leech therapy used to treat venous congestion after forearm flap reconstruction for oral cancer. A 67-year-old female was diagnosed with squamous cell carcinoma of the left tongue margin(cT2N0M0, Stage Ⅱ). The patient underwent tracheostomy, supraomohyoid neck dissection, hemiglossectomy, and reconstruction using a free forearm flap under general anesthesia. Venous congestion in the forearm flap was detected 21 hours postoperatively, and reanastomosis of the flap was performed. However, venous congestion continued after revision surgery. Therefore, we introduced medical leech therapy to treat the venous congestion. Leeches were used twice daily for 5 days, and the total hematophagy volume was 21.6 g. After leech treatment, continuous bleeding from the skin flap decreased and skin color improved. The medial skin flap survived, and the patient was able to eat 13 days after the initial operation. The rest of the treatment has been uneventful to date without dysfunction of the skin flap.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
67-year-old female with squamous cell carcinoma of tongue underwent forearm flap reconstruction; persistent venous congestion treated with twice-daily leeches for 5 days with successful flap survival.
Por qué esto importa para la hirudoterapia
Este reporte de caso describe a una mujer de 67 años que desarrolló congestión venosa tras una reconstrucción con colgajo libre de antebrazo por carcinoma escamoso oral. Tras el fracaso de la reanastomosis quirúrgica, se aplicó terapia con sanguijuelas medicinales dos veces al día durante 5 días, con un volumen total de hematofagia de 21,6 g. El colgajo sobrevivió, el sangrado disminuyó, el color de la piel mejoró y la paciente pudo alimentarse a los 13 días del postoperatorio. Este reporte es directamente relevante para la hirudoterapia, al documentar un desenlace clínico exitoso de la terapia con sanguijuelas para la congestión venosa del colgajo en la región oral. Sin embargo, se trata de un reporte de caso único sin grupo control, lo que limita la generalización.
Citación
[A Case of Medical Leech Therapy for Venous Congestion Following Forearm Flap Reconstruction].
Karino M et al. · Gan to kagaku ryoho, 2018
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026