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Leeches are hermaphroditic ectoparasites of the class Hirudinea. The most commnly used medicinal leech is Hirudo medicinalis. The salivary glands of leeches is known to improve blood flow, treat soft tissue swelling, periorbital hematoma, cauliflower ears, ecchymoses and purpura fulminans. Usually they are reserved to cases that are not amenable to surgical correction like gumboils and facial discoloration.

The procedure

Leeches are allowed to feed until they fall. That would be approximately 15-120 minutes time range. The wound continues to ooze due to the action of several substances present in the leech saliva. The leech has the ability to ingest 8-10 ml of blood. The wound ooze further to another 50 ml blood from the bite size. Success rate is known to be 70-80% of cases treated.

Place a drop of blood at the desired site of attachment. This will facilitate application of the leech. Encircle the site with surgical towels. Leech migration should be closely supervised.

Complications:

Leech therapy complications are usually associated with wound infection and bleeding. This often requires blood transfusion. Success rate normally drops to 30% in the presence of clinically significant infection. Immunosuppression or arterial insufficiency in the flap predisposes the patient to infection. The saliva of the leeches has anticoagulant properties. The leech bites are usually painless. Their bites usually leave a Y shaped scar to the area. A small risk of infection or allergy may also exist after the treatment.

Preparation:

Clean the skin area with normal saline. Barrier can be made with a 4x4 gauze sponge. Make a hole cut in the center of it. Then reinforce with towel. The leech transfer shall be made by the use of forceps and guided to the correct spot of the skin. Sometimes you need to prick the skin to draw blood. The leech will then show interest and start to feed.

What causes infection?

The leech will detach itself when full. If you pull it, mouth parts of the leech may be left in the wound and cause infection.

How to discard leech?

The detached leech is then placed in a cup covered in alcohol and discarded in an appropriate biohazard container.

Hematocrit and appearance of the skin should be monitored. Make sure that it is not losing  a lot of blood and the reattached body part is maintaining good circulation.

Warning: Never do this alone at home. Try to seek the help of a professional who specialized in leech therapy. There is so much at stake during the treatment. You have to coordinate with your doctor too about the therapy.