The use of medicinal leeches in microsurgery

Medicinal leeches have been used to treat a variety of ailments for thousands of years. During the past decade the leech has become valuable for salvaging surgically uncorrectable venous insufficiency which is occasionally encountered after microsurgical free flap and replantation procedures. Leech anatomy and physiology are reviewed. Indications and the technique for application of medicinal leeches is discussed, as well as potential complications of leeching.