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Leeches are
applied to venous congested flaps or
replanted fingers to relieve congestion
and vasodilate the microcirculation.
This results in bleeding of the leech
bite site for several hours after the
leech has filled its intestines and
fallen off. Hirudin, a powerful
anticoagulant that inhibits thrombin, is
secreted by the leeches and injected
into the flap or finger. The
continuous oozing of blood from the
replanted part or congested flap allows
inflow and outflow to continue until
neovascularization occurs, and blood can
drain via newly formed capillaries.
Leeches
are raised under strict conditions and
stored in a large tank, ready to spring
into action if needed.
Since
leeches are colonized with Aeromonas
hyrophila, a bacterium that can
cause soft tissue infection,
prophylactic antibiotics are begun at
the initiation of leech therapy. Typical
antibiotic prophylaxis is cefotaxime or
ciprofloxacin.
Leeching
can result in significant blood loss
over time, so blood counts need to be
done at least frequently.
The possibility of blood
transfusion increases with leech
therapy.
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