Effective Management of Venous Ulcer with Leech Therapy: A Case Report
Wani KR, Shah HA, Ashraf A, Nazir A, Mehraj M, Ansari AN, Nayab M (2025) · Advances in Mind-Body Medicine · n=1
Характеристика исследования
- Дизайн
- single Unani case report of medicinal leech therapy (Ta'liq al-'Alaq) applied across five sessions at 10-day intervals over 50 days to a venous ulcer on the right lower leg near the medial malleolus in a 42-year-old male presenting with pain, purulent discharge, hyperpigmentation, and impaired quality of life (Kashmir Tibbia College, Hospital and Research Centre, Bandipora, and Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India; with collaboration from National Institute of Unani Medicine, Kottigepalya, Karnataka)
- Размер выборки (n)
- 1
- Вмешательство
- Five sessions of Ta'liq al-'Alaq (Unani leech therapy) at 10-day intervals (days 0, 10, 20, 30, 40), with three Hirudo medicinalis leeches per session applied to the ulcer site; wound area, granulation tissue, epithelialization, pain, discharge, and smell assessed at each session
- Компаратор
- Not applicable - single-patient case report
- Первичная конечная точка
- Wound area reduction, granulation tissue formation, epithelialization, pain (visual analog scale), discharge, and smell at day 50
- Основной результат
- Wound area decreased from 8 cm x 5 cm x 4 mm at baseline to 2 cm x 1 cm x 0.5 mm at day 50; epithelialization increased from 0% to 80%; granulation increased from 20% to 80%; discharge and smell reduced from severe to absent; pain decreased from 8/10 to 1/10 on the visual analog scale; authors describe the case as illustrative of the Unani Ta'liq al-'Alaq regimen for chronic venous ulcers
- Длительность наблюдения
- 50-day treatment period plus assessment at each leech-therapy session
- PMID
- 40700533
Ключевые выводы
- Single Unani case demonstrating substantial wound reduction (>90% area decrease) and pain relief over 50 days
- Structured 5-session protocol at 10-day intervals — provides a reproducible regimen for further study
- Documents Indian Unani institutional practice for chronic venous ulcer
- Improvement across multiple wound parameters (size, granulation, epithelialization, discharge, smell, pain)
- Hirudo medicinalis specifically identified as the species used — methodological clarity
Ограничения
- Single case (n=1) - cannot establish generalizable efficacy
- No randomized comparator or sham control - placebo and expectancy effects not separable
- 27-year prior duration of ulcer makes spontaneous remission unlikely but does not exclude regression to mean in symptoms
- No microbiological or histological characterization of the wound bed
- Outcome assessment by treating Unani practitioner only - no independent assessor blinding
Клиническое значение
Wani 2025 documents structured 50-day Unani Ta'liq al-'Alaq leech therapy for chronic venous ulcer with substantial wound reduction. For US clinicians, the case is illustrative of the active Unani clinical-research program in Kashmir and adds to the broader leech-for-chronic-wound literature (Nayak 2008 diabetic foot ulcer, Ulla 2025 eczema). The case is hypothesis-generating only; controlled trials would be required to establish efficacy. The trial supports continued investigation of leech therapy as an adjunctive intervention for chronic venous and arterial ulcers and is included to document the active Indian institutional practice.