Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap
RCT published in Microsurgery (2010)
Abstract
INTRODUCTION: The originally described distally based sural flap technique has a risk of partial or total flap necrosis as high as 25%. The purpose of this study was to compare the medicinal leech therapy (MLT) with venous catheterization (VC) for blood volume removal, infection, wound dehiscence, and flap necrosis in the distally based sural flap with venous congestion. PATIENTS AND METHODS: Fifty-six conventional distally based sural flaps with venous congestion during reconstructive surgeries were randomly divided into two groups, MLT group and VC group. The results of comparisons were analyzed using SPSS software (SPSS for Windows Ver.11.5). RESULTS: There were significant differences in terms of the average volume of removed blood (53.6cc vs.172.2cc), infection (10.7% vs. 34.6%), wound dehiscence (10.7% vs. 42.3%), flap necrosis (3.6% vs. 19.2%), and nursing (7.8 vs. 5.19) and patient's satisfaction (8.03 vs. 5.6) in the VC group and MLT group, respectively. Although local heparin irrigation was performed in the VC group, the catheter was exchanged in 10 patients due to obstruction by clot. CONCLUSION: It is recommended that the VC be used for congested pedicled flaps instead of leech therapy, as VC is more effective, easy, and safe in blood removal, and it has less complication.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
RCT in 56 distally based sural flaps comparing leech therapy versus venous catheterization showed VC superior for blood removal (172.2 vs 53.6 cc), lower infection (10.7% vs 34.6%), dehiscence (10.7% vs 42.3%) and flap necrosis (3.6% vs 19.2%).
Por qué esto importa para la hirudoterapia
This randomized controlled trial compared medicinal leech therapy (MLT) with venous catheterization (VC) for treating venous congestion in 56 distally based sural flaps, evaluating blood volume removed, infection, wound dehiscence, and flap necrosis. MLT removed more blood volume on average (172.2 cc) than VC (53.6 cc); however, VC had lower rates of infection (10.7% vs. 34.6%), wound dehiscence (10.7% vs. 42.3%), and flap necrosis (3.6% vs. 19.2%). The authors concluded VC is more effective, easier, and safer than leech therapy for congested pedicled flaps. This study is directly relevant to ASH as it provides randomized comparative clinical data on leech therapy efficacy and complications against a mechanical alternative, suggesting specific limitations of MLT in this surgical context.
Citación
Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap.
Mozafari N et al. · Microsurgery, 2010
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026