The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits
Retrospective cohort published in J Hand Surg Am (2018)
Abstract
PURPOSE: A noteworthy cause of failure in digital replantation is venous insufficiency. External bloodletting with medicinal leeches is a common treatment for venous insufficiency after distal digital replantations. The objective of this study was to evaluate the salvage rate of digits replanted proximal to the distal interphalangeal (DIP) joint that were treated with medicinal leeches for venous congestion. METHODS: We retrospectively reviewed the charts of patients with complete or incomplete digit amputation admitted between January, 2008 and April, 2014. We included all patients with venous congestion in one or more digits replanted or revascularized at the middle or proximal phalangeal level, who were treated with medicinal leeches. Treatment initiation and duration were based on clinical judgment. Demographic, therapy, and surgical data were collected. RESULTS: Of 145 patients with 205 digits that were replanted or revascularized, 25 digits were treated with medicinal leeches for venous congestion. Venous congestion was diagnosed later than 48 hours after operation in 24 of the 25 digits. Of the 25 digits, 11 survived (44.4%) (8 of 22 replanted digits and all 3 revascularized digits). No complications were recorded except for substantial blood loss requiring transfusion in one patient. CONCLUSIONS: External bloodletting with medical leeches might be less effective with late treatment or with a higher volume of congested tissue, as is characteristic of proximal finger replantation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Of 25 proximal/middle-phalanx replanted digits treated with medicinal leeches for venous congestion, 11 (44.4%) survived. Late treatment (>48 hours post-op) and higher tissue volume both predicted lower salvage rates.
Por qué esto importa para la hirudoterapia
This study retrospectively reviewed 25 digits replanted or revascularized proximal to the DIP joint that were treated with medicinal leeches for venous congestion, drawn from 145 patients with 205 digits over a six-year period. The overall survival rate was 44.4% (8 of 22 replanted digits and all 3 revascularized digits), with venous congestion diagnosed later than 48 hours postoperatively in 24 of 25 digits; one patient required transfusion for substantial blood loss. This is directly relevant to ASH's domain as it provides clinical outcome data for hirudotherapy in a specific surgical application. Caveats: the study is retrospective (explicitly stated) with therapeutic level IV evidence and no concurrent control group, and the authors themselves suggest leech therapy may be less effective with late treatment initiation or larger volumes of congested tissue.
Citación
The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits.
Arami A et al. · The Journal of hand surgery, 2018
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: June 18, 2026