Recommendations for the use of leeches in reconstructive plastic surgery
Practice guideline published in Evid Based Complement Alternat Med (2014)
Abstract
A written informed consent should be obtained from the patient before hirudotherapy is initiated. The patients should be treated each day of leech therapy with anti-Aeromonas antibiotics. Leeches should be applied on the darker spots of the reattached body parts or flaps. Usually 1-10 leeches are used for each treatment, while at the beginning, the patient might need two or more treatments per day. Leech therapy is used until venous capillary return is established across the wound border by angiogenesis. Usually the treatment with leeches lasts for 2-6 days. Hematologic evaluations should be performed every 4 hrs and the patient has to receive blood transfusions when the hemoglobin level is lower than 8 g/dL. Signs of regional lymphadenitis, slight swelling, and pain of regional lymph nodes on the side of leech application and subfebrile temperature can occur. Contraindications related to hirudotherapy include arterial insufficiency, hemophilia, hemorrhagic diathesis, hematological malignancies, anemia, hypotension, and sepsis. Leech therapy is not recommended in pregnancy and lactation and in patients with an unstable medical status, history of allergy to leeches or severe allergic diathesis, and disposition to keloid scar formation, as well as in those using anticoagulants and immunosuppressants.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Comprehensive clinical-practice recommendations including informed consent, anti-Aeromonas antibiotics, 1-10 leeches per session, hematologic monitoring.
Por qué esto importa para la hirudoterapia
This article provides practical recommendations for using leeches in reconstructive plastic surgery, covering informed consent, daily anti-Aeromonas antibiotic prophylaxis, application technique (1–10 leeches on darker/dusky areas, often twice daily initially), typical treatment duration of 2–6 days until venous return is established, hemoglobin monitoring every 4 hours with transfusion below 8 g/dL, expected local reactions, and a detailed list of contraindications (arterial insufficiency, hemophilia, hemorrhagic diathesis, malignancy, anemia, hypotension, sepsis, pregnancy/lactation, allergy, keloid tendency, anticoagulant/immunosuppressant use). This is directly relevant to ASH as an applied clinical guidance document for hirudotherapy. The caveat is that the abstract does not specify the evidence base (systematic review, expert opinion, or narrative), and no outcomes or efficacy data are presented, so the recommendations should be read as practice guidance rather than proven standards.
Citación
Recommendations for the use of leeches in reconstructive plastic surgery.
Mumcuoglu KY · Evidence-based complementary and alternative medicine, 2014
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026