Gurbuz K¹, Ekinci Y¹, Doğar F²

¹Department of Orthopedics and Traumatology, Kayseri City Training & Research Hospital, Kayseri, Turkiye
²2Department of Orthopedics and Traumatology, Sutcu Imam University Hospital, Kahramanmaraş, Turkiye

*Corresponding Author: Kaan Gurbuz, Department of Orthopedics and Traumatology, Kayseri City Education and Training Hospital, Turkiye.

Received: November 21, 2022; Published: December 07, 2022

Abstract

Introduction: Hirudotherapy is an important integrative medicine application used with different indications and on a daily basis since ancient times. Herein aimed to present the clinical results of hirudotherapy in orthopedic trauma cases.

Patients and Methods: Twenty-one patients treated for extremity crush injuries accompanied by tissue loss between December 2017 and December 2020 and treated with surgery combined with hirudotherapy were included in this prospective study. The number of leeches used, demographic, clinical, and microbiological details were retrospectively analyzed to compare the postoperative clinical and functional results of the hirudotherapy.

Results: The mean age of the patients was 39.2 and the female to male ratio was 4:17. All patients underwent an average of 1.3 sessions of hirudotherapy per day. An average of 1 leech/9 cm2 was applied. Each session lasted an average of 21 minutes. Complications of hirudotherapy (infection, wound site and/or general allergy, etc.) were not encountered in any patient. Leech phobia was not observed in any of the patients before the application and did not develop after the application during the clinical follow-up.

Conclusion: The use of hirudotherapy for crush injuries shortens the patient's stay in the hospital, prevents soft tissue loss, and improves survival in flap surgery performed for tissue defects. Despite the fact that it is not ethically appropriate to perform controlled, double-blind, prospective, patient-based hirudotherapy studies to obtain evidence-based results, the benefits of hirudotherapy in clinical practice are apparent.

Keywords: Leech; Hirudotherapy; Flap; Trauma; Open Fracture

References

1. Gödekmerdan A., et al. “Medicinal leeches and hirudotherapy”. Türkiye Parazitoloji Dergisi 4 (2011): 234-235.
2. Signem AK., et al. “Medicinal leech therapy an overall perspective”. Integrative Medicine Research 6.4 (2017): 337-343.
3. White SS. “History of dental and oral science in America. American Academy of Dental Sciences”. Philadelphia (1876): 75.
4. Deganc M and Zdravic F. “Venous congestion of flaps treated by application of leeches”. Plastic and Reconstructive Surgery 13 (1960): 187-192.
5. Hayden RE., et al. “Leeches: Objective monitoring of altered perfusion in congested flaps”. Archives of Otorhinolaryngology-Head and Neck Surgery 12 (1988): 1395-1399.
6. Hallock GG and Rice DC. “Efficacy of venous supercharging of the deep inferior epigastric perforator flap in a rat model”. Plastic and Reconstructive Surgery 2 (2005): 551-555.
7. Chang H., et al. “Effect of venous super drainage on a four-territory skin flap survival in rats”. Plastic and Reconstructive Surgery 7 (2007): 2046-2051.
8. Dabb RW., et al. “The use of medicinal leeches in the salvage of flaps with venous congestion”. Annals of Plastic Surgery 3 (1992): 250-256.
9. Foucher G. “Distal digital replantation. One of the best indications for microsurgery”. International Journal of Microsurgery 3 (1981): 263-270.
10. Graham B., et al. “Major replantation versus revision amputation and prosthetic fitting in the upper extremity: a late functional outcomes study”. Journal of Hand Surgery 5 (1998): 783-791.
11. Enajat M., et al. “A single center comparison of one versus two venous anastomoses in 564 consecutive DIEP flaps: investigating the effect on venous congestion and flap survival”. Microsurgery 3 (2010): 185-191.
12. Chepeha DB., et al. “Leech therapy for patients with surgically unsalvageable venous obstruction after revascularized free tissue transfer”. Archives of Otorhinolaryngology-Head and Neck Surgery 8 (2002): 960-965.
13. Whitake I., et al. “Hirudo medicinalis and the plastic surgeon”. British Journal of Plastic Surgery 4 (2004): 348-353.
14. Furnas HJ., et al. “Blood loss associated with anticoagulation in patients with replanted digits”. Journal of Hand Surgery 2 (1992): 226-229.
15. Wells MD., et al. “The medical leech: an old treatment revisited”. Microsurgery 3 (1993): 183-186.
16. Chalain TM. “Exploring the use of the medicinal leech: a clinical risk-benefit analysis”. Journal of Reconstructive Microsurgery 03 (1996): 165-172.
17. Vanschoonbeek A., et al. “Outcome after urgent microvascular revision of free DIEP, SIEA and SGAP flaps for autologous breast reconstruction”. Journal of Plastic, Reconstructive and Aesthetic Surgery 69.12 (2016): 1598-1608.
18. Whitaker IS., et al. “Medicinal leeches and the microsurgeon: A four-year study, clinical series and risk benefit review”. Microsurgery 31.4 (2014): 281-287.
19. Boute N. “The use of leeches for venous congestion. A review and case report”. Veterinary and Comparative Orthopaedics and Traumatology 3 (2014): 173-178.

Citation

Citation: Kaan Gurbuz., et al. “Hirudotherapy in Orthopedics and Traumatology: Experiences from 21 cases”Acta Scientific Orthopaedics 6.1 (2023): 66-74.

Copyright

Copyright: © 2023 Kaan Gurbuz., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.