Indicators For Therapeutic Use Of Leeches

1. Plastic and Reconstructive Surgery. Leeches are generally useful on any
skin flap or other tissue suffering from impaired venous circulation. It is
prudent that a true venous congestion be diagnosed before using leeches
since they will not be helpful in cases of insufficient arterial inflow. Note,
also, that insufficient arterial supply could lead to infection from any
source, including leeches. The following criteria may help in diagnosing a
true venous problem in a flap:-

a. Skin colour dusky or bluish.
b. Capillary return bruskier than normal (note that areas of fixed
colouration are beyond salvage).
c. Pinprick response. Bleeding should be rapid and dark
d. History. Known problems with veins at operation, either in the pedile or
at the site of a micro-vascular anastomosis.
2. Oedema. Increasingly leeches are being used to treat severely
oedematous patients.