ReviewThe archives of bone and joint surgery2022
Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia/Reperfusion Injury: Benefits, Complications, and Contradictions.
Review in The archives of bone and joint surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 9 citations in OpenAlex.
- External Venous Drainage (EVD) System: A Standardized Bedside Technique for Venous Congestion in Free Flaps.Clinical case reports · 2026Article
- Case report: Heparin coagulant super-sensitivity during leech therapy.Thrombosis journal · 2026Article
- Salvage of pedicled anterolateral thigh flap for closure of a massive full-thickness abdominal wall defect using modified Perez protocol for chemical leeching-a case report.Journal of surgical case reports · 2026Article
- Molecular Insights into Leech-Derived Bioactive Compounds: Biochemical Mechanisms and Therapeutic Potential.International journal of molecular sciences · 2026Review
- Septic Gangrene and Thrombophlebitis Following Leech Therapy in a Patient with Undiagnosed Arterial Occlusive Disease: A Case Report.Iranian journal of medical sciences · 2025Article
- Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review.World journal of plastic surgery · 2024Review
- Phlegmasia cerulea dolens of the upper extremity treated with anticoagulation and leech therapy.Journal of vascular surgery cases and innovative techniques · 2023Article
- Umbilical Incarcerated Hernia With Omental Eventration Caused by a Leech Bite in a Pediatric Patient.Cureus · 2023Article
- Article
- Effect of ethanolic extracts from Piperaceae leaves on the reduction of skin necrosis and wound healing in an animal model of degloving injuries.Acta cirurgica brasileira · 2023Article
- LethalAntibiotics (Basel, Switzerland) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The use of free cutaneous or myocutaneous flaps in some surgeries, especially in reconstructive surgeries, is routine and imperative; nevertheless, it is controversial because of fear of flap loss due to tissue congestion and partial or complete necrosis. Different mechanisms are discussed in this process, and based on the involved mechanisms, various agents and approaches are suggested for flap salvage. Among these agents and strategies, leech therapy (hirudotherapy) can be a valuable complementary treatment; however, in this way, full attention should be given to all beneficial and harmful aspects to reach the best results. This study included a literature review of the essential complications following free tissue transfer and explained the effects of leech therapy for the respective complications. Based on the review of the literature, the essential complications following free tissue transfer were (I) venous obstruction and congestion, (II) delay in blood flow reestablishment, (III) ischemia/reperfusion injuries, and (IV) thrombus formation. Leech therapy can protect free flaps against the mentioned complications as a complementary treatment. Leech therapy is an appropriate complement, however, not a definite approach for flap salvage. Therefore, in some patients, other alternative methods or even flap removal may be a better option.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.