Leech management before application on patient: a nationwide survey of practices in French university hospitals
Research article published in Antimicrobial resistance and infection control (2018)
Abstract
BACKGROUND: Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. METHODS: Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. RESULTS: Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%), but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2), sulfamethoxazole/trimethoprim (2) or amoxicillin/clavulanic acid (1). CONCLUSIONS: Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%.
Por qué esto importa para la hirudoterapia
Esta encuesta nacional examinó las prácticas de manejo de sanguijuelas—almacenamiento, descontaminación externa, controles microbiológicos, trazabilidad de entrega y profilaxis antibiótica—en hospitales universitarios franceses que utilizan terapia con sanguijuelas en microcirugía plástica y reconstructiva. Los hallazgos son directamente relevantes para la hirudoterapia, y destacan una variabilidad significativa en los protocolos de prevención de infecciones y bajas tasas de profilaxis antibiótica sistemática, descontaminación externa y trazabilidad de lotes, todo lo cual incide en la seguridad del paciente y los resultados de rescate. Los autores abogan por directrices estandarizadas de buenas prácticas para reducir las complicaciones infecciosas, las cuales siguen constituyendo un riesgo clínico importante que puede reducir sustancialmente las tasas de rescate de colgajos. El estudio se limita a prácticas autoinformadas procedentes de centros franceses y no prueba ni compara intervenciones, por lo que caracteriza las lagunas en la práctica actual en lugar de establecer protocolos óptimos o demostrar la eficacia de ningún enfoque de manejo en particular.
Citación
Leech management before application on patient: a nationwide survey of practices in French university hospitals.
Grau D et al. · Antimicrobial resistance and infection control, 2018
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Añadido a la biblioteca ASH: March 18, 2026 · Última actualización del sitio: June 18, 2026