Leeches. Objective monitoring of altered perfusion in congested flaps.

In plastic and reconstructive surgery, there has been new interest in the use of the medicinal leech (Hirudo medicinalis) for the treatment of venous congestion. To the best of our knowledge, no study has been performed to objectively demonstrate the benefits of leeching a congested flap. Doppler laser perfusion monitoring (DLPM) was used to record blood flow changes in pig rump flaps compromised by venous occlusion. With the application of leeches to nine congested pig rump flaps, significant increases in blood flow were demonstrated both clinically and by DLPM. It is concluded from this study that DLPM can demonstrate objective improvement in microcirculatory perfusion with leeching.