Exploring the use of the medicinal leech: a clinical risk-benefit analysis
Risk-benefit analysis published in Journal of Reconstructive Microsurgery (1996)
Abstract
The medicinal leech, Hirudo medicinalis, has been used with increasing frequency for salvage of compromised pedicled flaps and microvascular free-tissue transfers. The data pertaining to 18 cases in which flap salvage with leeches was attempted were reviewed and contrasted with the data from 108 published cases from other centers. A further analysis isolated and examined 19 cases in which infection, secondary to leech utilization, supervened. Results suggested that successful salvage of tissue with leeches occurs in 70 to 80 percent of cases. In contrast, the infection rate of most series is between 7 and 20 percent and, when a clinically significant infection occurs, the flap salvage rate drops to 30 percent or less. In addition to infection, the risks of leech therapy include blood loss, which may require replacement transfusion, loss of leeches into body orifices and spaces, allergic reactions, and adverse psychological responses. Clinical indications and contraindications, and strategies to reduce the risks of leech usage, are discussed. Conclusions are that leeches are best used early, and in accordance with an accepted institutional protocol. For each case, the potential risks and benefits must be rigorously assessed and honestly applied.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Authoritative clinical risk-benefit analysis of medicinal leech therapy covering anticoagulant effect, blood loss, infection risk, allergic and ethical considerations.
Por qué esto importa para la hirudoterapia
Este artículo revisa 18 casos clínicos y 108 casos publicados del uso de la sanguijuela medicinal (Hirudo medicinalis) para el rescate de colgajos pediculados comprometidos y transferencias de tejido libre microvascular. Es altamente relevante para la American Society of Hirudotherapy, ya que aporta datos clínicos concretos sobre el perfil de riesgo-beneficio de la terapia con sanguijuelas, señalando una tasa de éxito de rescate tisular del 70 al 80 por ciento junto con una tasa de infección del 7 al 20 por ciento que reduce drásticamente el éxito del rescate. Si bien es exhaustivo, el análisis agrupa casos históricos sin un grupo control prospectivo estandarizado. El resumen enfatiza que el uso de sanguijuelas conlleva riesgos específicos —incluyendo pérdida sanguínea que requiere transfusión, reacciones alérgicas y repercusiones psicológicas— que exigen una evaluación rigurosa basada en protocolos en lugar de una aplicación casual.
Citación
Exploring the use of the medicinal leech: a clinical risk-benefit analysis.
de Chalain TM · Journal of reconstructive microsurgery, 1996
Contexto clínico relacionado
Explore cómo esta investigación se conecta con la práctica clínica
Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026