Leech therapy: when once is not enough
Research article published in Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (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
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.
Por qué esto importa para la hirudoterapia
Este estudio examinó directamente un desafío práctico en la hirudoterapia: si las sanguijuelas saciadas podían ser purgadas de sus ingestas de sangre e inducidas a realimentarse, permitiendo así su reutilización cuando la demanda supera la oferta. Usando solución salina hipertónica o presión manual para purgar las sanguijuelas, seguida de exposición a serotonina en concentraciones graduadas, los autores observaron que las sanguijuelas bañadas con serotonina volvieron a morder a una tasa aproximadamente cuatro veces mayor que los controles no expuestos (30% vs. 8%), aunque la realimentación efectiva se produjo solo en el 10% de las sanguijuelas tratadas, con ingestas de sangre significativamente más pequeñas que las alimentaciones iniciales. Este trabajo es muy relevante para el ámbito de la ASH, ya que aborda un verdadero cuello de botella logístico en la terapia con sanguijuelas para la congestión venosa en colgajos y replantes. Una advertencia clave es que, según la propia conclusión de los autores, el baño con serotonina no puede recomendarse para la reutilización rutinaria de sanguijuelas; la modesta tasa de realimentación solo puede servir como una solución provisional en emergencias cuando no se dispone de sanguijuelas frescas, y el estudio involucró una muestra limitada de 41 sanguijuelas tratadas.
Citación
Leech therapy: when once is not enough.
West B, Nichter L, Halpern D · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 1991
Contexto clínico relacionado
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Añadido a la biblioteca ASH: March 18, 2026 · Última actualización del sitio: June 18, 2026