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Objective: Medicinal leeches (Hirudo spp.) have been used for therapeutic purposes in humans since ancient times. Because of their growth conditions, leeches carry certain bacteria and endosymbionts (e.g., Aeromonas spp). In both leech farms and hirudotherapy clinics, there are no reliable antiseptics that can be used with leeches. This study aimed to determine whether methylene blue (MB) is a safe antiseptic for medicinal leeches and assess its safe usage. Methods: This study evaluated the efficacy of MB by determining lethal concentrations (LC), effective concentrations (EC), and lethal times (LT) for the medicinal leech Hirudo verbena Carena, 1820. A total of 570 H. verbana specimens obtained from a local farm were used in this study. Eighteen different concentrations of MB (between 1 ppm and 512 ppm) were tested. Results: The LC50 and EC50 values for H. verbana were determined to be 60.381 (53.674-66.636) ppm and 2.013 (1.789-2.221) ppm, respectively. The LT50 durations for MB concentrations of 32 and 512 ppm were calculated as 212.92 h (138.43 h-1485.78 h) and 17.82 h (8.08 h-23.90 h), respectively. Conclusion: The results show that MB concentrations between 2 and 19 ppm can be safely used as antiseptics in hirudotherapy clinics and leech farms to address bacterial concerns caused by medicinal leeches.

Background: In general practice, venous ulcers (stasis ulcers) are the most common and recurrent leg ulcers. Ignorance of it can have a severe detrimental effect on one's quality of life, cause gangrene, and even the limb amputation. Venous ulcers are the most dangerous and disabling side effect of chronic venous insufficiency. Leech therapy seems to be effective for the treatment of varicose ulcers due to its salivary secretions which it injects during bloodsucking. The saliva of leeches contains certain biochemical with vaso-dilating, anticoagulant, anesthetic, thrombolytic, antibiotic, analgesic, and anti-inflammatory properties. As a result, Irsal-e-Alaq (Hirudotherapy), one of the Unani regimens, can effectively control it. Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) on venous ulcers. Intervention: A 60-year-old male has a complaintof ulceration in his left lower leg near the medial malleolus with swelling, pain, discharge, and darkening of the skin of the left lower limb. Four leeches were applied once every week for 2 months. Efficacy of leech therapy was assessed on every 15th day by pain /leg discomfort on 4 point scale ranging from 0-3, limb girth at calf, ankle & foot, pigmentation color on 4 point scale, pigmentation area, pain in ulcer on 4 point scale from 0-3, ulcer depth, PUSH Score. Hb% was assessed every 15th day to check anemia, colour flow Doppler was done to assess any change in vein anatomy. Result: In this case report, the ulcers were completely healed, and also showed remarkable improvement in other variables. Conclusion: Irsal-e-Alaq has been proven beneficial in treating venous ulcers and enhancing patient’s quality of life. [ABSTRACT FROM AUTHOR]

The use of medicinal leeches in clinical therapy has been employed for a long time, as it was originally recognized for exerting antithrombin effects. These effects were due to the ability of the leech to continuously suck blood while attached to human skin. According to Chinese Pharmacopoei, leeches used in traditional Chinese medicine mainly consist of Whitmania pigra Whitman, Hirudo nipponia Whitman, and Whitmania acranulata, but the latter two species are relatively scarce. The main constituents of leeches are protein and peptide macromolecules. They can be categorized into two categories based on their pharmacological effects. One group consists of active ingredients that directly target the coagulation system, such as hirudin, heparin, and histamine, which are widely known. The other group comprises protease inhibitor components like Decorsin and Hementin. Among these, hirudin secreted by the salivary glands of the leech is the most potent thrombin inhibitor and served as the sole remedy for preventing blood clotting until the discovery of heparin. Additionally, leeches play a significant role in various traditional Chinese medicine formulations. In recent decades, medicinal leeches have been applied in fields including anti-inflammatory treatment, cardiovascular disease management, antitumor treatment, and many other medical conditions. In this review, we present a comprehensive overview of the historical journey and medicinal applications of leeches in various medical conditions, emphasizing their pharmaceutical significance within traditional Chinese medicine. This review offers valuable insights for exploring additional therapeutic opportunities involving the use of leeches in various diseases and elucidating their underlying mechanisms for future research. [ABSTRACT FROM AUTHOR]

BackgroundLeech therapy (LT) is one of the most widely used treatment methods in traditional medicine. The present study aimed to systematically review clinical trials regarding the effects of LT on the prevention and healing of different diseases.MethodsTo identify all relevant published studies, we conducted a comprehensive search of PubMed, Scopus, and Web of Science databases without any temporal or geographical constraints until April 2023. To categorize the articles, five stages were considered. The PRISMA checklist and Cochran’s bias analysis tool were used.ResultsIn total, 12 trials that met the inclusion criteria were studied. The results of the studies showed that LT has had successful outcomes in treating different conditions. These included hormonal and metabolic complications, cardiovascular problems, and inflammatory-based diseases.Conclusion“Leech therapy” is a traditional medical treatment used successfully to control and treat various conditions. Although this method can have complications, it is possible to benefit from this low-cost and low-complication treatment by taking preventive measures.

Background: Leeches therapy, also known as hirudotherapy, is one of the oldest methods used in medicine. Hirudotherapy treatments are increasingly used as a useful therapeutic method in the treatment of various diseases as an independent and complementary therapy. The method is used, among others, to treat pain, circulatory system diseases, diabetic complications, and arthritis. It is also effectively used by surgeons to treat venous diseases, hematomas, and wounds. Aim of the study: This article aimed to review the literature on hirudotherapy and its impact on eliminating pain. Material and methods: The analysis included articles from the pubMed and Google Scholar databases, including publications from 2010 to 2024. The keywords used were: leeches medicinal, hirudotherapy, pain. Results: A total of 15 out of 29 articles were qualified for the review. The search resulted in four randomized controlled trials, five case reports, two case series, two systematic reviews, and two meta-analyses. The research shows that the use of hirudotherapy can be an effective method in the treatment of pain in various clinical conditions. Both clinical studies and case reports confirm the effectiveness of this method for relieving pain. Conclusions: At this stage, it can be concluded that hirudotherapy can be an independent or supportive therapy in the treatment of pain in various diseases. Studies have differed regarding the use of leeches to treat pain. An important issue is determining the appropriate leech use regimen, including the number of leeches, frequency, and duration of use. [ABSTRACT FROM AUTHOR]

Background: The medicinal leech has been used in plastic surgery to resolve venous congestion that can threaten the viability of tissue transfer. Within the context of breast surgery, venous congestion is a pertinent consideration for reconstructive and non-reconstructive breast surgery such as mammoplasty and mastopexy. However, leeching is closely associated with complications such as infection, pain, and anaemia. This is the first systematic review that examines the methodology, efficacy, and post therapeutic outcome data across all existing studies on medicinal leeching in breast surgery. Methods: A systematic search of PubMed and Embase databases from their inception to November 2023 was conducted. Inclusion criteria included studies reporting on the use of leeches to resolve venous congestion in any breast surgery. The JBI Critical Appraisal Checklist for Case Series tool was used for bias analysis. Descriptive statistics were undertaken in Microsoft Excel. Results: A total of 18 studies with a combined sample size of 28 were examined, including 4 case series and 14 case reports. Patients mostly underwent reconstructive breast surgery (75%). The median number of leeches used was two, with a median number of three leeching sessions per day and 3 days of leeching. Medicinal leeching successfully prevented the loss of 75% of all tissue transfers. The complication rate was high at 81.14% and mainly included infection and anaemia. Conclusions: Medicinal leeching is an effective method to relieve venous congestion in breast surgery but must be judiciously used within the clinical context of the patient to maximise efficacy and mitigate harm from complications. [ABSTRACT FROM AUTHOR]

Copyright of Mersin University School of Medicine Lokman Hekim Journal of History of Medicine & Folk Medicine is the property of Mersin University School of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Leech extract contains many identified bioactive substances which have a variety of biological effects. Leech extract was discovered in the late 19th century and since then many pharmaceutical products have been produced using leech extract for different ailments, but many have been withdrawn. Ongoing studies focus on developing health authority compliant pharmaceuticals to be used as modern medicine. Methodology: The online databases including Google Scholar, Scopus, PubMed, and Web of Science, were searched using different keywords: ''Leech'', ''Leech extract'', ''Leech salivary gland extract'' and ''Leech saliva extract''. The purpose of this review was to discuss the development of leech extract as a therapeutic agent, including the evolution of extraction techniques, and the successful manufacturing of leech extract-based pharmaceuticals. Results: Leech extract has been successfully developed as a therapeutic agent. Some of the developed leech extract-based pharmaceutics were withdrawn and some are still in the market. The extraction methods played a vital role in the quality and efficacy of leech extract-based pharmaceutics and ultimately on their sustainability in the market. Also, the full characterization of leech extract components is a key factor in the development of leech extract as a therapeutic agent. Discussion: This review provides a comprehensive historical perspective on the development of leech extract therapy, exploring its various stages of development and the key scientific and medical advances that have shaped its current state. The discussion also delves into potential future applications. Conclusion: Leech extract is an invaluable source of bioactive substances that can be utilized for the treatment of mild and life-threatening medical disorders. This review will encourage other scientists to continue their research on leech extract, especially in the areas of formulation and marketing.

Background and Aim: The use of leech extract in the preparation of cosmetic supplements and medicinal compounds has always been of interest. So far, the effect of this extract on the volume of the skin's epidermal tissue has not been scientifically confirmed, and no research has been done regarding the comparison of the effects of different types of base oils in this extract. Methods: The purpose of this study was to investigate the effect of leech extract in the bases of olive oil, castor oil and bitter almond oil on the facial skin using the basic geometric morphometry software. For this purpose, 25 people from the age group of 45 to 55 years were selected. In order to compare morphological changes for forty days at a specific hour, pictures were taken using a digital camera. 12 landmark points were placed on the two-dimensional images using TpsDig2 software. The shape data obtained after superimposition analysis were analyzed using Procrust analysis with multivariate PCA and CVA statistical methods and cluster analysis (CV). Results: The results showed that there is a significant difference between leech extract in volumizing and removing wrinkles with olive oil base (P<0.001), but the two groups of castor oil and bitter almond oil did not have a significant difference (P>0.001). Conclusion: Leech extract has no effect on removing wrinkles and does not cause local swelling in the epidermal tissue in the time frame of the present study. [ABSTRACT FROM AUTHOR]

Abstract Background Medicinal leech therapy, otherwise known as hirudotherapy or leeching, has been utilized for numerous pathologies over centuries. The technique resurfaced in modern medicine for its beneficial effects in microsurgical complications, particularly venous congestion. Recently, several cases have documented the utilization of medicinal leech therapy for the management of urologic disease states and surgical complications. It is important to understand the past, present, and future possibilities for hirudotherapy in urology. However, a systematic review of medical leech therapy in this context has yet to be conducted. Accordingly, and with an emphasis on salient clinical details, this study aims to systematically review the cases of hirudotherapy applied to urological conditions. Main body of the abstract A systematic review of cases in MEDLINE/PubMed was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 49 search results, 11 articles detailing 13 unique cases of medicinal leech therapy used in the urological context were included. Hirudotherapy was conducted in 10 of 13 cases (76.9%) for the management of congested blood occurring in five cases post-penile replantation, two cases of postoperative scrotal hematoma, two cases of venous congestion of the glans post-neonatal bladder exstrophy repair, and one case of refractory priapism. Leeching in the remaining three cases was for the management of penoscrotal edema in patients with hormone refractory prostate carcinoma treated with radical radiation therapy. All 13 cases (100%) reported clinical improvement from hirudotherapy. Venous congestion/hematoma cases noted decreased displaced blood volume. The patient experiencing priapism reported decreased pain despite the persistence of cavernosal swelling. The three cases of penoscrotal edema reported significant decreases in swelling due to serous fluid drainage from leech puncture sites. No complications or side effects were reported in the nine adult patients. The four postoperative neonatal patients all required blood product throughout treatment. Short conclusion The systematic review of the cases demonstrates that medicinal leech therapy is a favorable treatment option for individuals with varied urological pathologies and that hirudotherapy may improve post-surgical outcomes in the urological setting. Hirudotherapy should be considered as a viable treatment modality in specific venostatic urological conditions.

Background: The most frequent and recurring type of leg ulcers seen in general practise is a venous ulcer (stasis ulcer). Its neglect has a considerable negative influence on quality of life, might result in gangrene, and may necessitate amputating the affected limb. The most serious and incapacitating complication of chronic venous insufficiency is venous ulcer. The conventional system of medicine offers limited clinical evidence for its effectiveness and usually needs amputation. Hence, it can be managed well by one of the Unani regimens, i.e., Irsal-e-Alaq (Hirudotherapy). Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) in venous ulcer. Intervention: A 53-year-old male who has complaints of ulcer in left lower leg near lateral malleolus with swelling, pain, discharge and darkening of skin of left lower limb. Four leeches were applied once every 15 days for 45 days. Ulcer was assessed on 0th day, 15th day, 30th day and 45th day on the basis of area of the wound in a square centimetre, appearance of healthy granulation tissues, epithelization in percentage and depth of wound in centimetres, pain (VAS scoring), discharge, smell and number of wounds. Results: on the first day wound size was 4 cm long, 3 cm wide, 2 cm deep and the floor filled with dark granulation tissue with 0 % epithelization, discharge, pain and smell. On the 45th day ulcer was completely healed with 100% epithelization. Conclusion: Irsal-e-Alaq has been proven beneficial in treating venous ulcers and enhancing patients' quality of life. To determine the effectiveness of Irsal-e-Alaq in the management of venous ulcer, rigorous, controlled, randomised, blinded, and long-term follow-up studies on high sample sizes are required. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Veterinary Medicine & Pharmacology is the property of Innovation in Health Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medical leech therapy, which has a history of thousands of years, is still the subject of many scientific studies today. These studies have shown that medicinal leech therapy has anticoagulant, antimicrobial, antiinflammatory and analgesic effects, as well as increases blood flow in the bite area. Due to these stated effects of leech therapy, it has potential benefits for patients experiencing wounds of the skin and tissues. This review focused on presenting the studies in which medical leech therapy is used to promote wound healing, particularly in post-traumatic wounds and non-healing chronic wounds. Additionally, this review aims to recognize medicinal leech therapy, introduce the leech species that have therapeutic effects and indicate the effect mechanisms of leech saliva on wound healing. The case series, single case reports and review articles on the use of medicinal leech therapy in wound healing were inspected. The original animal-based studies on wound healing were also investigated in this review for additional information. Various reports indicate that medicinal leech therapy has potential benefits for patients experiencing venous congestion of the skin and tissues, as well as varied types of ulcers. Medicinal leech therapy has promising potential in the healing of posttraumatic and chronic non-healing wounds. Nevertheless, more studies are needed for the potential effects of medicinal leech therapy in wound healing should be clarified by further studies. [ABSTRACT FROM AUTHOR]

This article aimed to determine the experts' opinion on the use of hirudotherapy in cosmetology, to supplement knowledge, and to identify factors that, in the opinion of experts, affect the effectiveness and frequency of use of this method in eliminating skin problems. The study was conducted using the expert interview method. The research tool was a categorized expert interview questionnaire using the CAWI (Computer Assisted Web Interview) technique. Hirudotherapy is one of the oldest healing methods. The mechanism of action is based on the therapeutic properties of bioactive substances isolated from leech saliva. It has been shown to have a wide range of applications in the treatment of numerous diseases in various fields of medicine, including dermatology and cosmetology. Despite its therapeutic properties and effectiveness, hirudotherapy is a rarely used tool in cosmetology. It has been found effective in the treatment of many dermatoses. The most spectacular effects have been observed in the treatment of rosacea, local inflammations, lipomas, skin scars, hard to heal wounds and contusions. [ABSTRACT FROM AUTHOR]

Leeches are hermaphrodite, bloodsucking parasitic worms usually found in places with fresh water. Leech therapy existed 3000 years, and it is being used at a different scope. Several species of leeches have been used in medicine, and the most common species used is Hirudo medicinalis. Leeches suck the excess blood, reduce the swelling in the tissues, and promote healing by allowing fresh oxygenated blood to reach the area until normal circulation can be restored. Pain relief from leech therapy is rapid, effective, and long-lasting in many conditions. The aim of this study was to evaluate the efficacy and duration of healing utilizing sterile medicinal leeches, Hirudinaria manillensis, in the management of pain and wound healing. Leech was taken out from its sterile tube by using a pair of non-tooth sterile plastic forceps and gloved hands. Each leech was left in place for as long as it was feeding. Leeches were removed only after they became detached from the patient. The specimen jars containing the used leeches were sealed in either a biohazard bag or in a small yellow clinical waste bin liner securely fastened with a cable tie. The leech was killed by using 70% alcohol prior to disposal into a yellow hazard bin, which undergoes incineration. All 3 patients had improvements in their condition, especially in terms of reduction in the pain and improvement in their sense of balance. All the wounds healed well. Therefore, leech therapy is effective in reducing pain and increasing perfusion to allow the wounds to heal quickly. However, a more robust trial is needed to show significance as the sample size is small. [ABSTRACT FROM AUTHOR]

BackgroundAcute limb ischemia due to microvascular malperfusion may be refractory to initial therapies. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and reconstructive surgery to improve venous congestion in ischemic flaps; however, there are minimal reports related to ischemia secondary to arterial malperfusion. We evaluated a pediatric cohort from an academic intensive care unit with refractory limb ischemia in whom hirudotherapy was attempted to elucidate its use and outcomes.MethodInstitutional patient database was queried to identify pediatric patients (

Intravaginal leech application is a traditional medical practice used in some cultures to treat various gynecological conditions. Leeches are believed to improve blood circulation and promote healing in the affected area. Studies have shown that the bioactive substances injected by leeches, when their mechanisms of action are examined, can be used in the treatment of many diseases. In this case report, we present a case of vaginal bleeding after intravaginal leech application. [ABSTRACT FROM AUTHOR]

Background: Leech therapy (LT) is one of the most widely used treatment methods in traditional medicine. The present study aimed to systematically review clinical trials regarding the effects of LT on the prevention and healing of different diseases., Methods: To identify all relevant published studies, we conducted a comprehensive search of PubMed, Scopus, and Web of Science databases without any temporal or geographical constraints until April 2023. To categorize the articles, five stages were considered. The PRISMA checklist and Cochran's bias analysis tool were used., Results: In total, 12 trials that met the inclusion criteria were studied. The results of the studies showed that LT has had successful outcomes in treating different conditions. These included hormonal and metabolic complications, cardiovascular problems, and inflammatory-based diseases., Conclusion: "Leech therapy" is a traditional medical treatment used successfully to control and treat various conditions. Although this method can have complications, it is possible to benefit from this low-cost and low-complication treatment by taking preventive measures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hosseini, Jadidi, Derakhshan Barjoei and Salehi.)

The course of all infectious diseases largely depends on immunity. An organism with a weak immune system gives up faster before diseases. Also, the number of immunodeficiencies with various etiologies has increased. Therefore, scientists are looking for various methods of dealing with these diseases. One such method is hirudotherapy using medicinal leeches, which has many therapeutic effects. As a result, the study of animals with a chemically immunosuppressive state has become relevant. The experiment was carried out on 45 mature male nonlinear rats with a body weight of 360-370 g. To simulate immunosuppression in experimental groups of animals, we used “Endoxan”. It was administered intraperitoneally to mature rats after the formation of 3 study groups: 1) control - without intervention; 2) “Endoxan” at a dose of 100 mg / kg; 3) “Endoxan” at a dose of 100 mg / kg + water-salt extract of Hirudo verbanа. After 3 weeks, the animals were measured for weight and body length, and were decapitated. Blood was taken with the addition of an anticoagulant. Then the total number of erythrocytes and leukocytes, the relative blood leukocyte formula, the mass and morphology of the thymus, the weight of the spleen and liver were examined. As a result, in the second and third groups, all indicators decreased, which indicates the immunosuppressive effect of the drug. After the introduction of the water-salt extract in the third group, the indicators increased (in some respects, even more) in comparison with the control group. [ABSTRACT FROM AUTHOR]

Lichen planus is a traumatic (koebner positive), chronic, inflammatory and autoimmune disease affecting the oral and genital mucosa, scalp and nails. The Food and Drug Administration approved the use of medical leeches for therapeutic purposes (hirudotherapy) in 2004 to ensure flap nutrition in plastic surgery. A 34-year-old male patient was admitted to our dermatology outpatient clinic with a swollen, itchy and purple-coloured rash on legs and back for a month, and white and reticulated plaques in the mouth. It was learned that a week earlier, eight leeches was applied to both knees and ankles to alleviate knee and leg pain. The patient had no history of drug use. A punch biopsy was taken from the patient with a preliminary diagnosis of lichen planus and lichenoid drug reaction. The histopathological examination showed hyperkeratosis, irregular acanthosis and hypergranulosis. Systemic methylprednisolone, levocetrizine and topical methylprednisolone aceponate were planned for the therapy. To the best of our knowledge, the appearance of lichen planus after hirudotherapy was never reported in literature. Hence, physicians should keep in mind that lichen planus and similar dermatoses could be triggered due to hirudotherapy. The fact that lichen planus appeared a week after hirudotherapy does not necessarily mean that leeches were the cause of this phenomenon. Accordingly, it could be deduced that lichen planus was probably developed as a result of leech therapy.

Chronic wound is one of a leading cause of amputation worldwide. Successful management of chronic wound has become a challenge to all existing medical systems across the world. Sri Lankan Traditional and Ayurvedic medicine reveals many promising herbal and alternative remedies for chronic wounds. We hereby report a successfully managed case of an 80-year-old female patient suffering from a chronic wound for two years, when presenting has advised for amputation of the leg. The treatment protocol included the application of hirudotherapy along with the bark paste of Pongamia pinnata followed by Flueggea leucopyrus with recommended other external and internal remedies. At the end of the treatment protocol, pain, exudates, odor, burning sensation, and itching were reduced completely while swelling and wound size was reduced remarkably and showed a significant healing in the wounded area.

Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort. Several protocols recommend blocking the path to the oropharynx via gauze or leaving a tracheotomy in place to protect the airway. This report pre-sents a novel technique for intraoral hirudotherapy that is safe and simple for treatment of free flap venous congestion. The base of a clear cup or a plastic lid is utilized, and the leech is attached onto the inside of the lid with 2 sutures near each end. Several cups with leeches attached are made at a time to reduce delay and difficulty of application by less experienced clinical staff. The leech is then applied onto the compromised flap and then simply removed once it has unlatched from the flap. This method allows the leech to be applied with ease by multiple members of the healthcare team, decreases the need for intraoral manipulation, and reduces the risk of migration into the aerodigestive tract. Future prospective studies are warranted to assess the efficacy of this technique. [ABSTRACT FROM AUTHOR]

Leech therapy or hirudotherapy is a well-recognized option for treatment of venous congestion in plastic and reconstructive surgery. It is clearly documented in our ancient Sanskrit text like 'Sushruta Samhita'. Recently, hirudotherapy has become an important modality in salvaging venous congested flaps. This prospective study of 1-year period was conducted at L.N. Medical College and J.K. Hospital, Bhopal, Central India. Leech therapy used in a total of nine patients in this study. Out of nine patients, five were males and four were females, with a mean age of 44 years (range 20 and 74 years). Free flaps were employed in two patients and pedicles flap was used in seven. Venous congestion in most of the patient appeared before 24 h. A number of leeches used ranged from 121 to 180 leeches per patient, with a mean of 150.8. The number of days of leeching was from 4 to 8 days, with a mean of 5.8 days. Blood transfusion required was from 1 to 5 units with a mean of 2.5 units. No local or systemic complications were observed in our study. The overall flap survival rate was 77.7% (7/9) with flap loss in two patients. Venous congestion is the most common cause of flap failure. Application of leech therapy is a helpful tool in salvaging the tissue transfer, not otherwise salvageable by surgical means. [ABSTRACT FROM AUTHOR]

Background: Hirudotherapy, also known as medicinal leech therapy, has been used to treat a wide range of disorders for thousands of years since Ancient Egypt. Leech therapy is also mentioned as a minimal invasive technique called Jalaukavacharana in the Sushruta Samhita, an ancient Sanskrit text of Ayurvedic medicine. Although hirudotherapy has become a popular component of complementary medicine in the last decade, scientometric studies investigating the articles published in this field, do not exist. Objective: In this study, we aimed to perform a detailed scientometric analysis of hirudotherapy literature. Materials and methods: We collected data by using four databases provided by Web of Science using the keywords “hirudotherapy”, “leech therapy”, “medicinal leech” and “medicinal leech therapy”. Results: A total of 834 articles were found of which 89.8% were original articles. USA was the leading country with 280 publications, followed by UK, Germany and France (128, 101 and 41 items, respectively). The most productive countries regarding hirudotherapy were the UK (1.93), Slovenia (1.44), and Israel (1.32). The peak publication year for hirudotherapy literature was 2011 with 41 papers. Conclusion: To the best of our knowledge, our study was the first bibliometric and scientometric analysis in this field and we believe that multicenter studies and further searches from developing and least-developed countries are needed in hirudotherapy literature.

Medical community has noted that the prevalence of allergic diseases by steadily tends to rise resulting from using synthetic drugs ecological catastrophe. In this regard, more and more attention is increasingly being paid to natural therapeutic approaches, one of which is based on applying hirudotherapy. There were used 40 pubescent outbred female rats and their 200 pups born during experiment. In particular, female rats underwent leeching in the subscapular region 2 weeks before and 2 weeks after mating by applying medical leeches weighing 400 ± 10 mg. Next, relevant progeny was examined at day 1, 15, 30, 45, and 60 after birth, whereas female rats– after weaning. Experiment was designed to assess diverse parameters in accordance with the age-related rat development: newborn pups – 1-5 days old, day 6-21 – suckling period, day 22-50 – onset of puberty, day 60 onward – puberty. After measuring body morphometric parameters, female rats were sacrificed by decapitation under ether narcosis on day 60, whereas rat pups – at various time points. followed by autopsy and collecting blood sample into a sterile centrifuge tube by using 2% Spofa crystalline heparin (8:1) to be further examined by standard assays: morphometry of rat body, spleen and thymus; measuring total leukocyte count; CBC with differential; RBC; hemoglobin level; color index. Statistical data processing was performed by calculating arithmetic mean, error of arithmetic mean, standard deviation by using SPSS version 21.0 and Microsoft Office Excel 2010 software. Significance of differences was estimated by using Student's t test, and set at p≤0.05. Our study demonstrated medical leech saliva components applied during hirudolotherapy exerted an immune-augmenting effect of on morphometric body, thymus and spleen parameters. Moreover, starting from day 1, total leukocyte count, RBC, and hemoglobin level were increased in the experimental group. Moreover, we convincingly demonstrated a stimulatory effect of medical leech saliva components on histogenetic reactions at various ontogenetic stages in both female rats and their progeny. In the former, such morphogenetic effect was maintained for more than 70 days after the last leeching: on week 2 after mating and 30 days after delivery. Changes in morphological and hematological evidence about enhanced morphogenetic function of immune system in response to saliva-derived biologically active substances released by medicinal leeches.

To evaluate the clinical and demographic characteristics of the patients who apply to Traditional and Complementary Medicine (TCM) center. The medical charts of patients, who were admitted to AIBU Izzet Baysal Physical Therapy and Rehabilitation Training and Research Hospital, TCM centre, from September 2018 to August 2019, were retrospectively reviewed. Only patients over the age of 18 were included in the study. 879 (84.4%) of the patients were female, 163 of them were (15.6%) male. 44 (4.2%) patients in the 18 - 24 age group, 137 (13.1%) patients in the 25 - 34 age group, 223 (21.4%) people in the 35 - 44 age group, 287 (27.5%) patients in the 45 - 54 age group, 205 (19.7%) patients were in the 55-64 age group, and 146 (14.0%) patients were in the age group 65 and over. Mean age of the patients was 48.64 ± 13.86 (19-87). 365 (35.0%) of TCM applications were made in spring, 266 (25.5%) in winter, 223 (21.5%) in summer and 188 (18.0%) in autumn. In this study, the most preferred TCM applications are acupuncture (48.1%), ozone therapy (34.3%) and mug treatment (13%), respectively. Determining by whom, in which age group and in which period of the year are more preferred TCM applications, which have been increasingly used in recent years, may prevent problems that may develop during the service delivery process. [Med-Science 2020; 9(1.000): 216-20]

Objective: Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics., Methods: All reports of adverse events involving hirudotherapy (product code "NRN") were retrieved from the U.S. Food and Drug Administration MAUDE database between 2012 and 2021. Antibiotic resistance was defined by bacterial culture or infection after antibiotic administration., Results: Nineteen cases of antibiotic resistance involving hirudotherapy were identified. Only three cases of antibiotic resistance were discovered on routine testing and the remaining 16 cases were associated with patient injury. Positive blood cultures or fever were present in 26.3 % (n = 5) of cases. Cultures of the infection grew Aeromonas hydrophilia (n = 13; 68.4 %), Vibrio vulnificus (n = 3; 15.8 %), Pseudomonas aeruginosa (n = 2; 10.5 %), and Proteus vulgaris (n = 1; 5.3 %). There were nine (47.4 %) multi-drug resistant infections. Infection was most commonly resistant to fluoroquinolones (n = 9; 47.4 %), trimethoprim-sulfamethoxazole (n = 9; 47.4 %) and ertapenem (n = 4; 21.1 %)., Conclusion: Antibiotic-resistant infections involving hirudotherapy are frequently resistant to multiple drugs, including fluoroquinolones and trimethoprim-sulfamethoxazole. Resistance to ertapenem, a drug of last resort, was also documented. The findings presented in this study support growing literature that the trend in multi-drug resistance is more severe than previously reported., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This article aimed to determine the experts’ opinion on the use of hirudotherapy in cosmetology, to supplement knowledge, and to identify factors that, in the opinion of experts, affect the effectiveness and frequency of use of this method in eliminating skin problems. The study was conducted using the expert interview method. The research tool was a categorized expert interview questionnaire using the CAWI (Computer Assisted Web Interview) technique. Hirudotherapy is one of the oldest healing methods. The mechanism of action is based on the therapeutic properties of bioactive substances isolated from leech saliva. It has been shown to have a wide range of applications in the treatment of numerous diseases in various fields of medicine, including dermatology and cosmetology. Despite its therapeutic properties and effectiveness, hirudotherapy is a rarely used tool in cosmetology. It has been found effective in the treatment of many dermatoses. The most spectacular effects have been observed in the treatment of rosacea, local inflammations, lipomas, skin scars, hard to heal wounds and contusions.

Objective: Medicinal leeches ( Hirudo spp.) have been used for therapeutic purposes in humans since ancient times. Because of their growth conditions, leeches carry certain bacteria and endosymbionts (e.g., Aeromonas spp). In both leech farms and hirudotherapy clinics, there are no reliable antiseptics that can be used with leeches. This study aimed to determine whether methylene blue (MB) is a safe antiseptic for medicinal leeches and assess its safe usage., Methods: This study evaluated the efficacy of MB by determining lethal concentrations (LC), effective concentrations (EC), and lethal times (LT) for the medicinal leech Hirudo verbena Carena, 1820. A total of 570 H. verbana specimens obtained from a local farm were used in this study. Eighteen different concentrations of MB (between 1 ppm and 512 ppm) were tested., Results: The LC 50 and EC 50 values for H. verbana were determined to be 60.381 (53.674-66.636) ppm and 2.013 (1.789-2.221) ppm, respectively. The LT50 durations for MB concentrations of 32 and 512 ppm were calculated as 212.92 h (138.43 h-1485.78 h) and 17.82 h (8.08 h-23.90 h), respectively., Conclusion: The results show that MB concentrations between 2 and 19 ppm can be safely used as antiseptics in hirudotherapy clinics and leech farms to address bacterial concerns caused by medicinal leeches.

Leech therapy is a safe, easy-to-use, cost-effective traditional treatment to save reattached body parts and flaps in reconstructive plastic surgery especially in cases with blood circulatory problems. [ABSTRACT FROM AUTHOR]

Applications related to the use of leeches in medical therapies date back for centuries. We present here a case of self-administered leech application for chronic low back pain who subsequently developed complication of chronic subdural hematoma. We are not aware of similar report in the literature. This was a 34-year-old man who was admitted to our Emergency Department with headache, right side numbness, and intermittent difficulty in speaking. During the neurological examination, it was observed that the patient had difficulty in speaking and pronouncing words intermittently while taking his medical history. Motor examination was normal. The patient did not report any recent trauma. There was no known history of systemic or hereditary disease, drug or substance abuse. Cranial CT and MR imaging showed a left frontoparietal chronic subdural hematoma. Further history was obtained that leech was applied to the patient for low back pain in the last 45 days, two times at 15 days intervals. The patient’s drowsiness and speech difficulties improved after the surgical operation. On one month follow-up, neurological examinations were normal. Our patient shows that leech therapy can be complicated by subdural hematoma. [ABSTRACT FROM AUTHOR]

Introduction: Disordered coagulation, clot formation and distal limb ischemia are complications of extracorporeal membrane oxygenation (ECMO) with significant morbidity and mortality. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and orthopedic surgeries to improve venous congestion and salvage ischemic flaps. To our knowledge this has not been reported in pediatric cardiac surgery or during ECMO support. We present a complex neonate whose ECMO course was complicated by distal limb ischemia for whom leech therapy was attempted.Patient and Intervention: A 2-week-old 2.7 kg infant required ECMO support secondary to perioperative multiorgan system dysfunction following repair of critical coarctation and ventricular septal defect. Despite systemic anticoagulation, his clinical course was complicated by arterial thrombus, vasopressor-induced vascular spasm and bilateral distal limb ischemia. Medicinal leech therapy was tried after initially failing conventional measures.Result: Following the third leech application, this patient developed significant hemorrhage from the web space adjacent to the left great toe. An estimated 450 ml of blood loss occurred and more than 300 ml of blood product transfusions were required. He ultimately progressed to irreversible systemic end organ dysfunction and comfort care was provided.Conclusion: The use of medicinal leech therapy in pediatric cardiac surgery may be considered to minimize the consequences of advanced limb ischemia and venous congestion. However, this should be used with caution while patients are systemically anticoagulated during ECMO support. A directed review is presented here to assist in determining optimal application and potential course of therapy. [ABSTRACT FROM AUTHOR]

The World Health Organization established a strategy on traditional medicine activities to facilitate integration of traditional medicine into the national health care system. Traditional and complementary medicine is now addressed by a legislation in Turkey. The aim of this study is to explore an integrative approach from for idiopathic granulomatous mastitis. This is a retrospective study. Study was carried out on idiopathic granulomatous mastitis patients who were followed in the Breast Clinic at Istanbul Medipol University Hospital for between May 2015 and September 2018. Hirudotherapy and medical cupping therapy were applied as traditional and complementary medicine integratively in accordance with the related Regulation. Radiological imaging, microbiological and histological testing, side effects, and relapses were analyzed. Radiological response was evaluated at the end of the treatment. Follow-up consisted of clinical breast exam and imaging. Thirty patients with a mean age of 34.6 years were analyzed. The average duration of symptoms was 4.6 months. Common symptoms were breast mass (100%), tenderness to palpation (73.3%), erythema (56.6%), fistula formation and deformity (43.4%), and axillary lymph nodes (43.4%). After confirmation of diagnosis of idiopathic granulomatous mastitis, patients were treated with hirudotherapy combined with medical cupping therapy. Symptoms had completely resolved within 110.3 ± 24.70 days (range 90–180) after starting treatment, and complete radiological response was confirmed 3 months after the end of the therapy by breast ultrasound or magnetic resonance imaging (MRI). All patients were successfully treated, and no evidence of relapse was experienced within the follow-up period of 22.87 ± 12.47 months. Hirudotherapy and medical cupping therapy were observed as efficient methods. Further investigations are required to validate the results in larger numbers of patients with longer follow-up. (ClinicalTrials.gov Identifier: NCT04096300). [ABSTRACT FROM AUTHOR]

A case of pregravid preparation is described for an in vitro fertilization (IVF) attempt in a woman after four previous IVF failures. Considering her personal and family aggravated medical history, including the family anamnesis, the patient underwent a hemostasis examination including a test for genetic mutations. A high titer of antiphospholipid antibodies of various types and multigene mutations associated with thrombophilia were found. For the treatment of acquired and inherited thrombophilia, vitamin-antioxidant and intravenous immunoglobulin therapy was initiated as well as a course of hirudotherapy. After starting of pregnancy throughout the gestation period, anticoagulant therapy by low molecular weight heparins, antiplatelet, and antioxidant therapy was carried out; in parallel, D-dimer, thrombin-antithrombin and platelet aggregation markers of thrombophilia were monitored. Pregnancy successfully ended by childbirth at 39 weeks.

Leeching was a popular therapeutic practice since ancient times for various diseases. Previously, it was used as an unscientific home remedy by traditional therapists. Currently, leech came back to contemporary medicine with few applications, which were demonstrated and held by an enormous number of scientific studies and case reports. Leeches are worms of the Phylum Annelida that feed on blood extracted from a host. Medicinal leeches have been evidently revealed to have a role in reconstructive surgery and replantation surgery. Literature exhibited the use of leeches in microsurgeries such as in skin flaps, replantation of amputated tissues of face, scalp, ears, fingers, and penis. Leech therapy increases the blood flow and neovascularization. This article highlights the comprehensive importance of leech therapy in the clinics of plastic and reconstructive surgery.

This historical review delves into the extensive and intriguing history of leeches in surgery. The utilisation of leeches in medical practice dates back thousands of years, from ancient civilisations to the modern era. The therapeutic properties of leeches have led to their persistent presence in surgical procedures. The 'Age of Leeches' during the 18th and 19th centuries witnessed a heightened utilisation of leeches in surgical treatment, given their perceived ability to promote postoperative wound healing and alleviate blood congestion. However, advancements in medical knowledge subsequently diminished their popularity as emerging technologies overshadowed them. Nevertheless, recent years have witnessed a resurgence in the use of leeches in reconstructive surgery, driven by both a greater understanding of their biological mechanisms and their potential source of therapeutic agents. This historical review provides a comprehensive exploration of the historical timeline, societal perceptions and scientific advancements surrounding the use of leeches in surgical practice., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Hirudoterapi, tıbbi sülükler kullanılarak yüzyıllar boyunca hastalıkları tedavi etmek amacıyla uygulanan bir tedavi şeklidir. Sülükler uzun yıllar boyunca terapötik olarak kullanılmıştır, ancak farmakoterapi ilerledikçe kullanımı azalmıştır. Günümüzde sülüklerin kan emmeleri esnasında ısırdığı dokuya verdiği salgısında biyolojik ve farmakolojik açıdan çok sayıda etkili biyoaktif maddeler tespit edilmiştir. Böylece konvansiyonel tedaviye ek olarak hirudoterapinin önemi her geçen gün daha iyi anlaşılmaktadır. Konu ile ilgili tıbbi sülük tedavisinin ülkemiz açısından önemini yeniden hatırlatmak ve güncel literatürü gözden geçirmek amacıyla bu derleme yazılmıştır.

Pseudolymphoma, also known as Jessner’s lymphocytic infiltration, is a benign but usually chronic, T-cell infiltrating disease with erythematous papules and plaques usually seen on the skin of the face, neck, and back. The use of leech therapy also known as hirudotherapy has increased in recent years. Here, we report a 52-year-old male patient who had undergone hirudotherapy in his neck and developed infiltrating plaques after four months. A skin biopsy confirmed the diagnosis of Jessner’s lymphocytic infiltration. In parallel with the increasing use of hirudotherapy in recent years, the side-effect reports will likely to increase. Indications and contraindications of hirudotherapy, which is being used officially in hospitals, should be taken into consideration.

Copyright of Journal of Traditional Medical Complementary Therapies is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Data from studies on the pathogenetic mechanisms of saliva secretion of medical leeches, which is an important producer of unique biological active substances (BAS), is summarized. These substances have a wide range of therapeutic effects, providing a prodounced anti-inflammatory, bacteriostatic, bactericidal, fibrinolytic, neurotropic, regenerative, energetic, immunomodulatory, anti-sclerotic effects. They regulate homeostasis, the circulatory system, lymph flow, all types of metabolic processes in the body and have no analogues in nature. We have presented the results of more than 20 years of effective experience in the use of hirudotherapy in otorhinolaryngology patients for medical, rehabilitation, and health purposes. Promising is the further study and application of hirudotherapy as a type of naturopathy and homeopathy in the 21st century of advanced technologies, significantly changing the conditions of the internal and external environment of the inhabitants of our planet. [ABSTRACT FROM AUTHOR]

The aim: to study the hirudotherapy effectiveness in case of osteoarthrosis as a pathogenetic therapy in view of vascular disorders in the disease pathogenesis. Material and Methods. 81 patients with ostearthrosis, predominantly gonarthrosis, aged 36 to 76 years old with a disease duration from 1 to 15 years were under observation. There were clinical and laboratory studies (generally accepted in patients with osteoarthritis), special studies included bulbar conjunctiva biomicroscopy and lower limbs rheovasography. Results. Hirudotherapy is a clinically effective method for the articular syndrome treatment in various types of osteoarthrosis. It is advisable to use the method in patients with a disease duration up to 15 years, with severe pain syndrome, concomitant peripheral veins pathology, and hypertension. Conclusion. The influence of hirudotherapy on the state of microcirculation in patients with osteoarthritis with the evaluation of the clinical effect and the rheovasography and conjunctival biomicroscopy was first studied, confirmed by instrumental methods. The greatest clinical efficacy was achieved with a high degree of local inflammatory activity, what once again emphasizes the role of microchemocirculation disorders in the development of synovitis in osteoarthritis.

Hirudotherapy (HT) is the submission of healing leeches (Hirudo medicinalis) for beneficial use. It is one of the firstborn medications, being active by several healing experts. HT contains the accessory of cultivated leeches against the pretentious zones. Leech treatment includes an original chew, which is frequently an easy mouthful, trailed by the slurping of 5 and 15 ml of blood. Its main healing assistances are not only owing to blood drunk during the piercing, but also from the many bioactive matters, such as Hirudin, Calin, Hyaluronidase, and Histamine-like ingredients, to name a scarce. HT has been active in numerous illness circumstances and clinical difficulties. It has been effectively used in soft and reconstructive operations, cardiovascular difficulties, varicose veins, hemorrhoids and various joint ailments. Nowadays, it is also being utilized in intestinal complaints, dermatology and antenatal irregularities. More newly, HT has created new claims in tumor healing, sensitivity situations, like asthma, male/female sterility and diabetes. Attractive into deliberation all the truths, HT labors should be made in improving the achievement of remedial leech therapy in scientific and isolated practice. [ABSTRACT FROM AUTHOR]

We retrospectively reviewed 201 digit replantations or revascularizations that were performed between August 2007 and June 2015. Leeching therapy was used in 48 digits and was more commonly required in replanted digits. In revascularized digits, leeching was used significantly more frequently in avulsion injuries and injuries associated with fractures. Digits that were leeched for more than 4.5 days had significantly higher rates of survival of digits after replantation or revascularization. Leeching was associated with higher incidence of transfusion, higher mean number of transfusions, and longer length of stay. We conclude from this study that leeching is used more frequently after digital replantation than revascularizaion, and in revascularized digits, leeching is used more often in avulsion injury and in patients with fractures. In patients requiring leeching therapy, leaching for more than 4.5 days leads to higher rate of digital survival.Level of evidence: IV [ABSTRACT FROM AUTHOR]

Objective. to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years. Materials and methods. From archive data of previously examined 8,136 males' CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosimetry data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclusion zone from the end of 1986 to 1992-1994 amounted to 0.21-0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients' auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40-49 and 50-59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used. Results. Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in presbyacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6-9 months comparing to 12-18 months of hiruditherapy one, being twice longer. Improving the patients' coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox. Conclusions. It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopatotherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clinical practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality. [ABSTRACT FROM AUTHOR]

Copyright of Likarska Sprava is the property of J. Likarska Sprava and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)