title: Clinical and scientific considerations in leech therapy for the management of acute venous congestion: an updated review.
abstract: Any surgical intervention that involves the manipulation of veins, large or small, carries the risk of acute venous congestion. Venous congestion is the product of an imbalance between arterial inflow and venous outflow, and results in the stasis of blood in the tissues that are normally drained by the affected veins. The resultant lack of tissue perfusion causes hypoxia, acidosis, and arterial thrombi formation, which can potentially progress to tissue necrosis and wet gangrene. In the past several decades, the use of leeches (Hirudo medicinalis) has been rediscovered as an effective method of relieving acute venous congestion. This updated review of leech therapy focuses on the use of medicinal leeches in a variety of clinical conditions characterized by acute venous congestion, and points out the experimental use of leeches in other pathological entities. A discussion of the recent scientific findings that explain the possible mechanisms of action of leech therapy is also provided.
authors.affiliation: DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Weinfeld
authors.forename: E
authors.initials: E
authors.lastname: Yuksel
authors.forename: S
authors.initials: S
authors.lastname: Boutros
authors.forename: D H
authors.initials: DH
authors.lastname: Gura
authors.forename: M
authors.initials: M
authors.lastname: Akyurek
authors.forename: J D
authors.initials: JD
authors.lastname: Friedman
mesh_terms: D000818:Animals; D000991:Antithrombins / Q000627:therapeutic use; D005385:Fingers / Q000098:blood supply; D024764:Hirudin Therapy; D006801:Humans; D007865:Leeches; D007866:Leg / Q000098:blood supply; D011182:Postoperative Care / Q000379:methods*; D012307:Risk Factors; D014689:Venous Insufficiency / Q000628:therapy*
chemical_list: D000991:Antithrombins