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Comparing a mechanical device with medicinal leeches for treating venous congestion
Gregory K Hartig1, Nadine P Connor, Dennis M Heisey
1University of Wisconsin-Madison Medical School, Department of Surgery, Division of Otolaryngology, K4/720 Clinical Science Center, 600 Highland Ave, Madison, WI 53792, USA. hartig@surgery.wisc.edu
Summary
Mechanical device therapy and medicinal leech therapy show comparable results for venous congestion in porcine flaps. However, device therapy demonstrated more comprehensive decongestion, evidenced by improved skin color over time.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Regenerative Medicine
Background:
- Venous congestion is a significant complication in reconstructive surgery, potentially leading to flap failure.
- Medicinal leech therapy has been a traditional method for managing venous congestion.
- Novel mechanical devices offer a potential alternative for treating venous congestion.
Purpose of the Study:
- To compare the efficacy of mechanical device therapy versus traditional medicinal leech therapy in treating venous congestion.
- To evaluate the impact of both therapies on flap viability and decongestion parameters.
Main Methods:
- A porcine model with 9 x 7-cm fasciocutaneous flaps was used, with venous clamping for 15 hours.
- Flaps were treated with either mechanical devices (n=6) or medicinal leeches (n=5).
- Outcomes assessed included blood volume, skin color, perfusion, oxygen tension, and histology.
Main Results:
- No significant differences were observed in blood volume removed, surface perfusion, or tissue oxygen tension between the two groups.
- Significant differences were noted in skin color changes over time, favoring device therapy.
- Histological analysis revealed mild congestion in 5/5 leech-treated flaps compared to 2/6 device-treated flaps.
Conclusions:
- Mechanical device therapy is a viable alternative to leech therapy for managing venous congestion in flaps.
- Device therapy appears to promote more global decongestion than leech therapy, as indicated by improved skin color.
- Both therapies were comparable in decongesting a 9 x 7-cm flap over a 15-hour period.