Medical leech therapy used to assist with traumatic amputations

Leech tank

5 West nurses Abby Watkin and Allanah Clare with the medical leech tank at SVHM

Leech therapy is a centuries-old medical approach that has been adopted in modern practice at some hospitals today for very specific indications.

Specially-bred medical leeches have been used by the Plastic and Reconstructive Surgery Department at St Vincent’s Hospital Melbourne (SVHM) since the 1970s.

The tiny organisms have been found to be useful in microsurgery treatment, particularly in replanting body parts that have been traumatically amputated.

A medical leech can help re-establish the blood flow balance in the amputated part after replantation surgery through its ability to suck blood. Its saliva has anaesthetic, anti-inflammatory and anti-coagulant properties that also assist with the process.

“They (medical leeches) are not frequently used but can be a valuable resource to us in difficult cases. These organisms can sometimes mean the difference between saving a finger and failing to replant it,” said Mr Pedro Aguilar, a Plastic and Reconstructive Surgeon at SVHM.

SVHM is a major referral centre for hand trauma, and leech therapy has been largely applied at the hospital to support these types of injuries. Other times when it may be used include amputation injuries sustained to ears, nose, and scalp.

Helping to balance blood flow

Medical leech therapy is typically applied soon after replantation surgery in patients where an imbalanced blood flow in the amputated part, called venous congestion, is evident, and where further surgery is not a viable option.

A small incision is made where the leech can attach itself to the patient. The therapy generally takes about 5-7 days for new blood vessels to grow across a suture line to help restore a consistent blood flow and enable angiogenesis (the process where new blood vessels are formed in the replanted body part) to occur.

If there are issues experienced with blood getting out of a piece of tissue, then leeches can help temporarily until the new blood vessels form and allow normal blood flow to resume.

“The leeches are able to draw about 5 to 10 millilitres of blood at any one time,” Mr Aguilar said.

“Being able to restore the blood flow using this traditional form of therapy in patients where more surgery is not a possibility is very satisfying. It’s good to have this extra option in our toolkit,” Mr Aguilar said.

Between 6-10 patients each year undergo leech therapy at SVHM, where up to 40 medically-bred leeches are stored in a tank on site.

“While it is not our common practice to use leech therapy, the outcomes for the patients we have used it on have been very positive,” Mr Aguilar said.

Mr Aguilar featured on House of Wellness where he spoke about medical leech therapy. Watch the story here.