Leech therapy: when once is not enough
Experimental study published in Blood Coagul Fibrinolysis (1991)
Abstract
Venous congestion is a constant threat in the survival of free flaps, pedicled flaps, tissue replantations and traumatized tissue. Leech therapy has proved effective in salvaging much of these compromised tissues. To be effective, leeches must be both readily available and hungry, requirements not always easily met. Our investigation seeks to establish a means to return sated leeches to their previous unfed, hungry state for reuse. Sated leeches were purged of their blood meals by placement in 3% hypertonic saline or by gentle finger pressure, then exposed to serotonin 0 microM (control), 10 microM, 30 microM or 90 microM for 20 min. Subsequent rebiting/refeeding was observed and analysed. Leeches bathed in serotonin rebit or reattached at nearly four times the rate of unexposed leeches; 30% vs 8% respectively. Biting, however, is not refeeding. Overall, 41 leeches were treated with serotonin with four (10%) refeeding. Those that refed consumed a significantly smaller blood meal than the initial feeding; 50% +/- 47% SD vs 348% +/- 143% SD of original body weight. None of the control group refed. As a method for routinely reusing leeches, serotonin bathing cannot be recommended. In the immediate postoperative period with the sudden emergence of venous congestion requiring leech therapy, but with an inadequate number available, this 20% [corrected] refeed rate after 10 microM serotonin exposure could potentially determine the success or failure of the flap/replantation until fresh leeches are made available.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Serotonin bathing of sated leeches induced rebiting in 30% versus 8% control but only 10% refeeding with smaller blood meals (50% vs 348% body weight), insufficient for routine leech reuse.
Por qué esto importa para la hirudoterapia
Este estudio investigó si las sanguijuelas saciadas podían devolverse a un estado de hambre para su reutilización purgando las ingestas de sangre mediante solución salina hipertónica o presión manual, seguida de exposición a serotonina a distintas concentraciones. Los hallazgos mostraron que las sanguijuelas bañadas en serotonina volvieron a morder o se readhirieron a casi cuatro veces la tasa de los controles (30 % frente a 8 %), pero la realimentación verdadera fue mucho menor —solo el 10 % de las sanguijuelas tratadas con serotonina se realimentaron, consumiendo ingestas significativamente más pequeñas que las iniciales. Los autores concluyen que el baño con serotonina no puede recomendarse para la reutilización rutinaria de sanguijuelas, aunque una tasa corregida de realimentación del 20 % con serotonina a 10 microM podría servir como solución de emergencia cuando se disponga de sanguijuelas insuficientes. Esta investigación aborda una limitación práctica de suministro en la hirudoterapia, aunque la baja tasa de realimentación limita la utilidad clínica y no se reportan resultados reales en pacientes.
Citación
Leech therapy: when once is not enough.
West BR et al. · Blood coagulation & fibrinolysis, 1991
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026