title: Medicinal leech therapy on head and neck patients: a review of literature and proposed protocol.
abstract: OBJECTIVE
  To this day, a standardized protocol for medicinal leech therapy does not exist. The purpose of this article was to review literature in the hope of proposing a unified, coherent, feasible, and safe protocol for using medicinal leeches when warranted.
  
  
  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.
  
  
  RESULTS
  Based on titles and abstracts, 26 articles and 1 Web site were identified.
  
  
  CONCLUSIONS
  Leech therapy can be an excellent alternative for the treatment of venous congestion in free flaps, pedicled flaps, and replanted tissues. Psychological precounseling, antibiotic therapy, number of leeches to be used, length of therapy, and laboratory checks should be taken into consideration before initiating therapy.
authors: Department of Oral & Maxillofacial Surgery, Darnall Army Medical Center, Fort Hood, Texas 76548, USA. aelyassi@gmail.com
authors: Ali R
authors: AR
authors: Elyassi
authors: Jayson
authors: J
authors: Terres
authors: Henry H
authors: HH
authors: Rowshan
mesh_terms: D000818:Animals; D002985:Clinical Protocols; D005260:Female; D016489:Head Injuries, Closed / Q000628:therapy*; D024764:Hirudin Therapy / Q000379:methods*; D047709:Hirudo medicinalis; D006801:Humans; D006940:Hyperemia / Q000628:therapy*; D024763:Leeching / Q000379:methods*; D008297:Male; D019838:Neck Injuries / Q000628:therapy*; D018919:Neovascularization, Physiologic / Q000502:physiology