title: Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry.
abstract: A universal protocol determining the number of leeches and their application time does not exist. The aim of this study, therefore, is to quantify perfusion dynamics in venous congested tissues after leech application to get more detailed information about changes due to leech-induced skin microcirculation and to evaluate the usability of the Oxygen to See (O2C) device in terms of determining the appropriate number of leeches and the duration of therapy. Twelve patients with the need for leech therapy participated in the study. Perfusion dynamics of the congested tissue was assessed using the O2C device, which determines blood flow (BF), the relative amount of hemoglobin (rHB), and the oxygen saturation (SO2). Measurements were carried out before leech application and on various intervals like 10 minutes, one hour, and three hours after leech application. The leech application effectuated after 10 minutes a nonsignificant perfusion improvement, which further increased after one hour with a significant reduction of the relative amount of hemoglobin and a significant increase of blood flow and oxygen saturation (BF= +56.7%; rHB= -25.5%; SO2= +53.7%). After three hours, the values returned to the levels before leech administration. In two cases, in which further administration of leeches within the measurement period was necessary, no substantial perfusion changes were obtained. The results of this study forms a more precise pattern of microcirculatory changes of leech therapy in congested tissues. According to our measurements a venous drainage improvement can be expected in congested tissue one hour after leech administration. The O2C seems to be a useful method to determine the appropriate number and duration of leech therapy.
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Rothenberger
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Petersen
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Held
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D024763:Leeching / Q000379:methods; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000378:metabolism; D017410:Practice Guidelines as Topic; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D013053:Spectrophotometry; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors; D014652:Vascular Diseases / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology
chemical_list: D010100:Oxygen