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Leech therapy in reconstructive maxillofacial surgery.

Alexander Gröbe1, Andreas Michalsen, Henning Hanken

  • 1Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. a.groebe@uke.de

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|May 10, 2011
PubMed
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Medical leech therapy effectively treats venous congestion in reconstructive surgery flaps, improving healing outcomes. This approach is a reliable addition for managing postoperative hemodynamic imbalances and venous insufficiency.

Area of Science:

  • Plastic and Reconstructive Surgery
  • Vascular Surgery
  • Biomedical Therapies

Background:

  • Reconstructive surgery often involves tissue flaps (local, pedicled, microvascular) to repair large defects from trauma, burns, or cancer.
  • A significant complication is venous congestion due to vascular issues like spasm or collapse, jeopardizing flap survival.
  • Medical leech therapy is an established treatment for managing compromised wound healing linked to hemodynamic imbalance or venous insufficiency.

Purpose of the Study:

  • To evaluate the efficacy of medical leech therapy in managing venous congestion in various types of reconstructive surgery flaps.
  • To assess the impact of leech therapy on wound healing in patients experiencing postoperative hemodynamic imbalances or venous insufficiency.

Main Methods:

  • A retrospective analysis of 148 patients undergoing reconstructive surgery with local, pedicled, or microvascular flaps between 2005 and 2010.

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  • Patients received medical leech therapy for symptomatic venous congestion in their flaps, despite standard postoperative care measures.
  • Data collection focused on flap healing outcomes following leech therapy.

    • Main Results:

    • Medical leech therapy demonstrated excellent and predictable healing in flaps treated for venous congestion.
    • The therapy proved effective for both local/pedicled and microsurgical anastomosed flaps.
    • Successful outcomes were observed even after initial attempts to relieve congestion, such as suture removal or hematoma evacuation.

    Conclusions:

    • Leech therapy is a reliable and advantageous adjunctive procedure in plastic and maxillofacial reconstructive surgery.
    • It effectively addresses complications arising from hemodynamic imbalance or venous insufficiency in the immediate postoperative period.
    • Incorporating leech therapy can significantly improve flap viability and patient outcomes.