Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review
Cohort series published in Microsurgery (2011)
Abstract
BACKGROUND: There are case reports and small series in the literature relating to the use of medicinal leeches by plastic surgeons; however, larger series from individual units are rare. The aim of this article is to present a comprehensive 4-year case series of the use of medicinal leeches, discuss the current evidence regarding indications, risks, and benefits and highlight the recent updates regarding leech speciation. METHODS: Patients prescribed leeches in a 4-year period (July 2004-2008) were collated from hospital pharmacy records (N = 35). The number of leeches used, demographic, clinical, and microbiological details were retrospectively analyzed. RESULTS: Thirty-five patients were treated with leeches. The age range was 2 to 98 years (mean = 49.3). Leeches were most commonly used for venous congestion in pedicled flaps and replantations. Blood transfusions were necessary in 12 cases (34%) [mean = 2.8 units, range 2-5 units]. Our infection rate was 20% (7/35) including five infections with Aeromonas spp. (14.2%). The proportion of patients becoming infected after leech therapy was significantly greater in the group of patients that did not receive prophylactic antibiotic treatment (Fisher's Exact test P = 0.0005). In total, 14 cases (40%) were salvaged in entirety, in 7 cases 80% or more, in 2 cases 50 to 79%, and in 1 case less than 50% of the tissues were salvaged. In 11 cases (31%), the tissues were totally lost. CONCLUSION: Our study highlights both the benefits and the risks to patients in selected clinical situations and also the potential risks. The routine use of antibiotic prophylaxis is supported. In view of the emerging evidence that Hirudo verbana are now used as standard leech therapy, and the primary pathogen is Aeromonas veronii, until a large prospective multicenter study is published, large series of patients treated with leeches should be reported.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Four-year case series of 35 patients prescribed leeches: 34% required blood transfusion, 20% developed infection (14% Aeromonas), 40% had complete tissue salvage. Patients without antibiotic prophylaxis had significantly higher infection rates.
Por qué esto importa para la hirudoterapia
This article presents a retrospective 4-year case series of 35 patients treated with medicinal leeches for venous congestion in pedicled flaps and replantations, reporting a 20% infection rate (7/35) including five Aeromonas spp. infections. The study found that infection was significantly more frequent in patients who did not receive prophylactic antibiotics (P = 0.0005), supporting routine antibiotic prophylaxis, and noted emerging evidence that Hirudo verbana is now the standard species used and Aeromonas veronii the primary pathogen. This is highly relevant to ASH, offering real-world outcome and safety data from a sizable clinical series. Caveats include its retrospective design and relatively small sample from a single unit, limiting generalizability.
Citación
Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review.
Whitaker IS, Josty IC, Hawkins S et al. · Microsurgery, 2011
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: June 18, 2026