Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry
Rothenberger J, Petersen W, Schaller HE, Held M (2016) · Wound Repair and Regeneration · n=12
Характеристика исследования
- Дизайн
- single-center prospective observational study using tissue spectrophotometry and laser Doppler flowmetry to quantify perfusion dynamics during leech therapy (BG-Trauma Center, Eberhard Karls University Tuebingen, Germany)
- Размер выборки (n)
- 12
- Вмешательство
- Single leech application to venously congested tissues with serial Oxygen-to-See (O2C) device measurements of blood flow (BF), relative hemoglobin (rHB), and oxygen saturation (SO2) before and at 10 minutes, 1 hour, and 3 hours post-application
- Компаратор
- No randomized comparator - within-subject repeated measurements over time
- Первичная конечная точка
- Blood flow, relative hemoglobin, and oxygen saturation in congested tissues at 10 minutes, 1 hour, and 3 hours after leech application
- Основной результат
- Significant improvements at 1 hour post-application: BF +56.7%, rHB -25.5%, SO2 +53.7%; values returned to baseline by 3 hours; further leech administration within measurement period produced no substantial additional perfusion change; authors propose the O2C device as a useful real-time guide for protocol optimization
- Длительность наблюдения
- 3 hours per leech application episode
- PMID
- 27733014
Ключевые выводы
- First study to quantify the time course of perfusion improvement in venously congested tissue after leech application using validated optical biosensors
- Significant perfusion improvement at 1 hour: blood flow +56.7%, relative hemoglobin -25.5%, oxygen saturation +53.7%
- Perfusion benefits returned to baseline by 3 hours - clinically meaningful for protocol timing
- Tissue spectrophotometry (O2C device) proposed as real-time guide to leech application protocol
- Provides objective biomarker confirmation of the venous-decongestion mechanism in microsurgical flap salvage
Ограничения
- Small sample (n=12) and single center
- Observational design without randomized comparator
- Short follow-up (3 hours) within each application episode
- Mechanism study rather than clinical outcome study
- O2C device not yet routinely available in many US plastic surgery units
Клиническое значение
Rothenberger 2016 provides objective biomarker confirmation that medicinal leech therapy produces measurable venous decongestion in clinically congested tissues. The time course (peak benefit at 1 hour, return to baseline by 3 hours) directly informs protocol timing recommendations - particularly the standard 4-12 hour rotation interval used in microsurgical flap salvage. For US clinicians, the study supports the mechanistic basis for leech therapy in venous congestion and provides a candidate biomarker (tissue spectrophotometry) that could improve protocol standardization in future trials.
Связанные исследования
Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review
Whitaker IS, Josty IC, Hawkins S, Azzopardi E, Naderi N, Graf J, Damaris L, Lineaweaver WC, Kon M (2011)
Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap
Mozafari N, Ghazisaidi MR, Hosseini SN, Abdolzadeh M (2010)
Chemical and mechanical alternatives to leech therapy: a systematic review and critical appraisal
Azzopardi EA, Whitaker IS, Rozen WM, Naderi N, Kon M (2011)
HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW
Heinz P, Tvrdý P, Pink R, Dvořák Z, Michl P (2020)