The use of leeches in distal digital replantation
Long-term case series published in Blood Coagul Fibrinolysis (1991)
Abstract
Over the past 18 years we have operated on 50 patients who had sustained distal amputation of fingers. Their average age was 30 years (range 2-72 years). Replantation of radial digits on the right hand was most common and the thumb was involved in nearly half the cases in our series. Out of the 50 cases we were able to repair both arteries in 35 patients and only one artery in the other 15. Regarding veins, two were anastomosed in 12, only one in 23 and none in 15 because of the severity of the contusion or the very distal site of replantation. Although early arterial thrombosis usually leaves no solution other than reoperation, venous complications can be relieved by ancillary methods such as leeches which we first used in 1976. We encountered a venous problem in 16 (32%) out of the 50 cases. In three cases a venous anastomosis had been performed, but in 13 others it proved impossible. If congestion was mild, paraungeal or pulpar incision provided some relief because of repeated topical application of heparin and systemic heparinization. If congestion was severe, leeches were used on average for 6 days at a frequency of four to six leeches a day. All cases where leeches were used could be salvaged. One can assess through this sequence that the use of leeches in distal digital replantation has improved the survival rate by 26%.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Across 50 distal finger replantations over 18 years, venous complications occurred in 32% of cases. All cases treated with leeches (4-6 daily for 6 days) were salvaged; estimated 26% absolute improvement in survival rate compared to no leech use.
Por qué esto importa para la hirudoterapia
Esta serie clínica recoge 50 casos de reimplante digital distal a lo largo de 18 años, con congestión venosa en 16 casos (32%). Cuando el flujo venoso de salida no pudo restablecerse quirúrgicamente o la congestión era grave, se aplicaron sanguijuelas medicinales durante aproximadamente 6 días a razón de cuatro a seis sanguijuelas por día. Los autores comunican que todos los casos tratados con sanguijuelas se salvaron, estimando una mejoría del 26% en la supervivencia atribuible al uso de sanguijuelas. Para el ámbito de ASH, este estudio aporta evidencia clínica directa que apoya la terapia con sanguijuelas como rescate para la congestión venosa en el reimplante digital distal. La principal salvedad es que abarca casi dos décadas de experiencia sin un grupo de comparación; la cifra del 26% refleja la valoración de los autores más que un análisis controlado, y los desenlaces pueden reflejar el manejo global más que la sanguijuela por sí sola.
Citación
The use of leeches in distal digital replantation.
Baudet J · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 1991
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026