Hirudotherapy in Wound Healing

Nair HKR, Ahmad NW, Lee HL, Ahmad N, Othamn S, Mokhtar NSHM, Chong SSY (2020) · The International Journal of Lower Extremity Wounds · n=3

Детали доказательств RCTСсылка на исследование

GRADE Очень низкаяНедостаточно доказательствЛечение пиявками при других заболеваниях

Это исследование (выделено) по размеру выборки наряду с другими включенными в индекс исследованиями Лечение пиявками при других заболеваниях. Более крупные исследования, как правило, имеют больший статистический вес.

Характеристика исследования

Дизайн: single-center case series of hirudotherapy for chronic wound management (Hospital Kuala Lumpur and Institute for Medical Research, Malaysia)
Размер выборки (n): 3
Вмешательство: Sterile medicinal leeches (Hirudinaria manillensis) applied to chronic wounds and pain sites until detached spontaneously; full sterile-technique protocol with non-tooth plastic forceps and biohazard disposal
Компаратор: No randomized comparator - descriptive case series outcomes
Первичная конечная точка: Pain reduction, wound healing progression, and patient-reported balance/comfort outcomes
Основной результат: All 3 patients showed improvements in their condition, especially reduction in pain and improvement in sense of balance; all wounds healed well; authors conclude hirudotherapy is effective but note small sample size and need for more robust trials to establish significance
Длительность наблюдения: until wound resolution
PMID: 32815407

Ключевые выводы

Malaysian hospital-based case series documenting hirudotherapy protocols using Hirudinaria manillensis (Asian medicinal leech)
All three patients reported pain reduction and improvement in balance/comfort metrics
Detailed sterile-technique and biohazard-disposal protocol documented
Authors explicitly call for larger, more robust trials to confirm significance
Uses a different leech species (H. manillensis) than the European H. medicinalis - adds species coverage to the literature

Ограничения

Very small case series (n=3) - hypothesis-generating only
No randomized control or sham comparison
Mixed wound etiologies in the case series limit attribution to specific pathology
Different leech species (Hirudinaria manillensis) not FDA-cleared in the US
Outcomes assessed by treating clinicians without standardized blinded scoring

Клиническое значение

Nair 2020 documents the Malaysian government-hospital approach to hirudotherapy for chronic wound healing using a non-European leech species (Hirudinaria manillensis). For US clinicians, the species difference limits direct applicability under the FDA K040187 clearance framework, which specifies whole-leech H. medicinalis. The case series provides useful operational documentation of sterile-technique and biohazard-disposal protocols but cannot establish efficacy at any meaningful evidence level. The trial supports calls for larger species-specific RCTs in chronic wound healing.

Связанные исследования

The Effectiveness of Leech Therapy in Chronic Low Back Pain

Hohmann CD, Stange R, Steckhan N, Robens S, Ostermann T, Paetow A, Michalsen A (2018)

Hirudotherapy for limb ischemia in the pediatric intensive care unit: a retrospective observational cohort

Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A (2023)

Study of the effect of leeching on plasma endothelin and soluble interleukin-2 receptor in patients with systemic lupus erythematosus

Cheng SP, Liu JL, Yuan J (2005)

Medicinal leech therapy in pain syndromes: a narrative review

Koeppen D, Aurich M, Rampp T (2013)

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