Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Original articleMedicinal leech therapy on head and neck patients: a review of literature and proposed protocol
Section snippets
Material and Methods
A literature search was conducted in the following databases: PubMed, MDConsult, The Cochrane Library, OMIM, and Google. This was supplemented by a search for selected authors. Keywords used were medicinal leech therapy, leech therapy, leeching, replantation, thromboembolism, venous congestion, Hirudo medicinalis, Hirudotherapy, leech protocol, and Hirudo protocol. Based on titles and abstracts, 26 articles and 1 Web site were identified.
Pertinent data were then extrapolated from these articles
Discussion
The process of imbibition and inosculation for graft neovascularization takes 96 hours to complete, according to Jordan.19 Leech therapy can therefore be used to temporarily reestablish venous outflow until permanent outflow is established.17, 19 Hence, leech therapy is especially indicated in a situation in which tissue exhibits dark-purple discoloration that can be suggestive of venous congestion.20
Leeches effectively reduce venous congestion by removing blood directly and by injecting
Proposed Protocol
After review of literature, case studies, and different protocols that have successfully worked for different institutions, the authors of the article suggest the following. First of all, choose the appropriate candidate. The patient should not have a previous allergic reaction to or psychological fear of leeches. Once venous congestion has been identified and the patient has agreed to undergo leech therapy, it is important to explain to the patient the process in detail and what to expect.
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Medicinal leech therapy on head and neck patients
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Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this Journal.