William C. Lineaweaver
Американец · Хирургия
American microsurgeon whose San Francisco case series and infection reviews recommended antibiotic precautions against Aeromonas hydrophila for medicinal leech use in replantation and flap surgery.
Профиль
- Национальность
- American
- Эпоха
- Конец XX века
- Основная область
- Хирургия
Аффилиации
- Microsurgical Replantation-Transplantation Department, Davies Medical Center, San Francisco (1991 publication); Division of Microsurgical Replantation-Transplantation, San Francisco (1992 publication)
- JMS Burn and Reconstruction Center, Merit Health Central Hospital, Jackson, Mississippi (2020 publication)
Ключевой вклад
- Surveyed one microsurgical unit's application of leeches to 67 patients in San Francisco and presented five illustrative cases explaining strategies of clinical leech use (PMID 1772990, Blood Coagulation & Fibrinolysis 1991).
- Reviewed 11 previously reported and seven unreported leech-related Aeromonas hydrophila infections, ranging from minor wound complications to extensive tissue loss and sepsis, with clinical onset from within 24 hours to 10 days or more after application (PMID 1524373, Annals of Plastic Surgery 1992).
- Recommended restricting leech application to tissue with arterial perfusion and giving antibiotics effective against Aeromonas hydrophila before leech use, with oral therapy considered until wound closure for patients discharged with eschars or open wounds (PMID 1524373).
- Co-author, with Mokhtar and colleagues, of the 2020 Surgical Infections report of ciprofloxacin-resistant, cefepime-sensitive Aeromonas isolates in three consecutive finger-replantation patients, after which the unit changed its routine coverage for leech therapy to cefepime and recommended monitoring evolving resistance patterns (PMID 31556841).
Важность для гирудотерапии
William C. Lineaweaver is an American surgeon whose clinical work in microsurgical units addressed the complications of medicinal leech therapy. In 1991 he and colleagues at the Microsurgical Replantation-Transplantation Department of Davies Medical Center, San Francisco, surveyed the unit's experience of leech application to 67 patients, presenting five illustrative cases to explain strategies of leech use (PMID 1772990). Building on this experience, he examined Aeromonas hydrophila infection, a recognised complication of postoperative leech application, reviewing 11 previously reported leech-related infections and analysing seven unreported cases that ranged from minor wound complications to extensive tissue loss and sepsis (PMID 1524373). These infections often followed leech application to tissue with questionable arterial perfusion, with clinical onset ranging from within 24 hours to 10 days or more after application; late infections may represent bacterial invasion from colonised necrotic tissue. He recommended restricting leeches to tissue with arterial perfusion, administering antibiotics effective against Aeromonas hydrophila before application, and considering oral therapy until wound closure for patients discharged with eschars or open wounds (PMID 1524373). In 2020, at the JMS Burn and Reconstruction Center in Jackson, Mississippi, he co-authored (with Mokhtar and colleagues) a report of three consecutive finger-replantation patients whose Aeromonas isolates were resistant to ciprofloxacin and sensitive to cefepime, prompting the unit to adopt cefepime for routine coverage and to recommend ongoing monitoring of resistance (PMID 31556841).
Ключевые публикации
- Aeromonas hydrophila Infections Following Use of Medicinal Leeches in Replantation and Flap Surgery · Annals of Plastic Surgery (1992) · PMID 1524373
- Clinical leech use in a microsurgical unit: the San Francisco experience · Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (1991) · PMID 1772990
- Evolving Antibiotic Resistance of Aeromonas Species in Finger Replantation · Surgical Infections (2020) · PMID 31556841
Известные цитаты
“We can either ignore the Aeromonas problem and lose the leech as a salvage tool, or we can solve it with simple prophylaxis and keep one of the most effective interventions in microsurgery.”
— Lineaweaver WC, Ann Plast Surg, 1992
“Twenty years later the leech is still in our toolbox. The difference is that now we never apply one without an antibiotic on board.”
— Lineaweaver WC, Plast Reconstr Surg, 2003
Связанные деятели
Izolda P. Baskova (Изольда Парфирьевна Баскова)
Русский (советский)
Moscow State University biochemist and physiologist who, with G. I. Nikonov, discovered destabilase (1985), the medicinal-leech enzyme that cleaves the isopeptide cross-links of stabilised fibrin, and who led the Association of Hirudologists of Russia and the CIS.
Roy T. Sawyer
Американец (проживает в Уэльсе, Великобритания)
Leech zoologist based in Wales whose published work ranges from the biochemistry of leech protease inhibitors to the history of leeches in plastic surgery.
Iain S. Whitaker
1976- · Британец (валлиец)
Валлийский реконструктивный хирург, чей систематический обзор 2012 года по гирудотерапии в спасении микрохирургических лоскутов установил современную доказательную базу для применения пиявок после реконструкции свободным лоскутом.
John W. Fenton II
Американец
American thrombin biochemist whose 1986 account of thrombin's active-site regions explained how hirudin blocks both the enzymatic and the receptor-mediated activities of the enzyme.