Medical Leech Treatment
What is Hirudotherapy?
Hirudotherapy is a form of treatment using the creature known as “leech” in Turkish, whose medical name is “Hirudo Medicinalis”, which is included in the class of ringworms. In hirudotherapy, leeches are attached to the appropriate points and it is aimed for the creature to bite, thus giving the bioactive molecules it contains to the area. These bioactive substances have anticoagulant (blood clarifier), myorelaxant (muscle relaxant), immunomodulator (immune regulator) and microcirculation regulator (circulation) properties.
What is its history?
It is one of the oldest known treatment methods in medicine. It has more than 2000 years of history. It is found in ancient Egyptian inscriptions, Hippocrates’ practices and Ibn Sina’s works. In 2004, the FDA Food and Drug Administration approved leech therapy for the recovery of amputated limbs in the field of plastic surgery. Today, it is mostly used for this purpose in modern medicine.
What kind of creature is a leech?
There are more than 800 species, belonging to the group of ringworms, typically with a dorsoventral flat body. It has 3 jaws and 100 teeth in each jaw. It is composed of segments and the anterior and posterior segments are specialized with the name “cecum”. The front segment contains the mouthpart while the rearmost segment is used for attachment to the surface. There are more than 100 bioactive compounds in the leech’s secretion. Some of them are hirudin, calin, destabilase, hirustatin, tryptase inhibitor, eglin (prevents clotting), hyolurinidase (increases viscosity, antimicrobial), histamine-like substances (increases blood flow in the bitten area)
How is the Application?
No preparation is required before the application. Since leeches are sensitive to chemical odors, odors such as perfume and detergent make the application difficult. The sweaty surface also makes it difficult to hold on. The surface is cleaned in a sterile way. Then the leech is brought into contact with the point to be applied and held on. While biting movement is felt at first, no pain is felt throughout the procedure due to the local anesthetic substances secreted by the leech. As a result of the procedure lasting 20-60 minutes, the leech spontaneously leaves the place it holds. In some cases, it may need to be provoked to leave. At the end of the procedure, a clean and tight dressing is applied to stop the bleeding quickly. Bleeding between 4 hours and 24 hours is normal.
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In Which Diseases Can It Be Used?
In the legislation, it is currently used for pain reduction in varicose venous diseases, osteoarthritis (joint calcification) and tendon inflammations such as lateral epicondylitis (tennis elbow). However, much more extensive research in the literature has been conducted in the field of hirudotherapy.
Are There Side Effects?
There may be an allergic lesion at the application site. There may be itching for 1-2 weeks and scarring that may last for a few months.
Does it have a place in the scientific literature?
There are hundreds of studies in the scientific literature about Hirudotherapy (Leech Therapy). Some of these are as follows:
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- General Studies on Hirudotherapy:
- https://www.ncbi.nlm.nih.gov/pubmed/31289001
- https://www.ncbi.nlm.nih.gov/pubmed/26817000
- https://www.ncbi.nlm.nih.gov/pubmed/26427330
- https://www.ncbi.nlm.nih.gov/pubmed/26342505
- https://www.ncbi.nlm.nih.gov/pubmed/25484274
- https://www.ncbi.nlm.nih.gov/pubmed/22069059
- https://www.ncbi.nlm.nih.gov/pubmed/19769685 (History)
- https://www.ncbi.nlm.nih.gov/pubmed/15975313
- Painful Diseases:
- Use in various surgeries, especially reconstruction:
- https://www.ncbi.nlm.nih.gov/pubmed/30881774
- https://www.ncbi.nlm.nih.gov/pubmed/30692309
- https://www.ncbi.nlm.nih.gov/pubmed/30636508
- https://www.ncbi.nlm.nih.gov/pubmed/30157119
- https://www.ncbi.nlm.nih.gov/pubmed/29344982
- https://www.ncbi.nlm.nih.gov/pubmed/27392815
- https://www.ncbi.nlm.nih.gov/pubmed/23996135
- https://www.ncbi.nlm.nih.gov/pubmed/21550156
- https://www.ncbi.nlm.nih.gov/pubmed/15465249
- In osteoarthritis
- In Venous Congestive (Ponding) Diseases (varicose veins etc.)
- Urological Diseases:
- Skin Diseases:
- https://www.ncbi.nlm.nih.gov/pubmed/28844218 (Kutanöz Leishmaniazis)
- https://www.ncbi.nlm.nih.gov/pubmed/24809835 (Diyabetik Ayak)
- https://www.ncbi.nlm.nih.gov/pubmed/24804186 (Epidermoid Kistlerde)
- In Colevestibular Diseases (Ear-hearing-balance)
- Oral and dental diseases:
- https://www.ncbi.nlm.nih.gov/pubmed/12666550 (Salivary Gland Diseases)
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