History of Leech Therapy Leech therapy has a long history. Records indicate that Egyptians used leech therapy 3,500 years ago. Dhanvantari, the Hindu God of Medicine, was first referenced in the 8th century B.C.E., and he is depicted as holding a leech in one of his four hands. Leech treatments were very popular during the Middle Ages. Again leech therapy was commonly practiced in the 1800s by American physicians treating a variety of diseases. In the 1980s, medicinal leech therapy got a big boost by plastic surgeons who used leeches to relieve venous congestion, especially in transplant surgery. This use of leech therapy (hirudotherapy) provides a good example of its current status. When appendages are re-attached following traumatic amputation, it is often possible to reconnect the larger arterial blood vessels, but not the thinner, more delicate venous vessels. The body will eventually develop the necessary venous connections to drain the area of oxygen-depleted blood; but if this does not occur rapidly enough, the pooling venous blood can produce enough swelling and pressure that fresh arterial blood may no longer be able to enter the re-connected limb. In this situation, leeches are used to drain the local blood and decompress the pressure within the grafted limb, otherwise at risk of necrosis (death). Today, medicinal leeches are also used in the treatment of other venous diseases such as thrombophlebitis, as well as angina pectoris, arthritis, hematomas, and even tinnitus. Clinical Practice of Leech Therapy The application of leech therapy is simple: leeches are gently placed in the area needed, and allowed to attach and engorge (usually within 1 hour), after which they will release. The entire course of treatment may require one to 6 treatments or more, depending upon the goals and rate of response. For more details about the specific application procedures, readers are referred to the manufacturers directions. A list of manufacturers can be found elsewhere on this site. Leeches (Hirudo Medicinalis) have been used medically for more than 1500 years. Originally used to remove “bad blood,” the leech is now used extensively by reconstructive surgeons needing to remove stagnant blood from a flap or reattached limb. When the venous blood does not return to the heart, it pools in the wounded area, increasing pressure and preventing fresh arterial blood from entering the area with oxygen and nutrients. The venous blood must be removed and the pressure must be reduced in order to save the flap or limb. The leech is able to do this exceptionally well, because its saliva contains important biochemicals, including vasodilators, anticoagulants, and anesthetics. The leech will withdraw approximately 5 ml (one teaspoon) of blood. Further therapeutic benefit of leech therapy comes after the leech is removed, during which up to 50 mls of blood will continue to ooze, for up to 48 hours. More leeches attached to the site mean more blood will be removed. After 3-7 days, the veins have usually reconnected themselves such that the blood is no longer pooling in the limb. Normal color and pressure should return to the area, as arterial blood circulates easily in the damaged zone. By that time, the wound will be able to heal, without further phlebotomy (leech therapy). The application of leeches to the patient is relatively simple, but does require care. As few as one, or as many as 6 or more leeches may be required for a wound, depending upon its size and its clinical response. The greatest number of leeches should be applied to the area of maximal venous congestion. The patient’s skin must be cleaned thoroughly with soap and water, and then rinsed with distilled, non-chlorinated water. A gauze barrier around the area intended for the leech will help prevent the leech from wandering away from the site where it’s attachment is desired. It can be carried to the site by hand, or it can be placed within a 5 cc plastic syringe (plunger removed) and then applied to the wound site, containing the leech until it is attached. If the leech is reluctant to bite, it might be necessary to entice it with a tiny droplet of blood, drawn from the wound site with a needle prick. Once the leech is attached, it will likely remain safely in place until fully distended. The gauze square can be removed and used elsewhere without disturbing the animal;however, it is important that the site be checked continuously to insure that the leech hasnt moved. The leech will let go of the patient (host) when it is finished (usually within an hour).
Posted on: Mon, 24 Nov 2014 05:02:15 +0000
Trending Topics
Recently Viewed Topics
© 2015