Augmented blood removal after medicinal leech feeding in congested tissue flaps.

Reconstructive microsurgery is performed to reattach, transfer, or transplant body tissues. Venous congestion is a complication that threatens the viability of the affected tissue and is often treated with medicinal leeches. Leech therapy has two phases: active bloodletting and passive bleeding from the leech wound after detachment, which can last for several hours.

Development of a mechanical device to replace medicinal leech (Hirudo medicinalis) for treatment of venous congestion.

Medicinal leeches are used to treat venous congestion, a complication of reconstructive surgery. Despite substantial drawbacks of leeching, little progress has been made to develop a device that would replace the leech for this purpose. The goal of this study was to develop and test mechanical prototypes for the treatment of venous congestion.

Cutaneous tissue flap viability following partial venous obstruction.

Background: Venous outflow obstruction is the most common cause of tissue failure after microvascular reconstructive surgery. If it is not recognized early, there is an increased risk of tissue damage and loss. Currently, however, there are no adequate models for the study of this clinical problem.

Comparing a mechanical device with medicinal leeches for treating venous congestion.

Objective: To compare mechanical device therapy to medicinal leech therapy for treating venous congestion.

Study Design: Fasciocutaneous flaps of 9 x 7-cm (porcine model, n = 11) were elevated and the associated veins clamped for 15 hours. Device-treated flaps (n = 6) were treated with up to 3 devices/flap.

Testing a device to replace the leech for treating venous congestion.

Objective: To test the effectiveness of a device designed to promote decongestion and tissue survival of a fasciocutaneous flap during 15 hours of complete venous obstruction.

Methods: In a porcine model, a 9 x 7-cm fasciocutaneous flap was elevated and the associated veins were clamped, causing complete venous obstruction for 15 hours in 6 control and 6 treatment animals. Up to 3 devices were used to treat the flap in a predetermined pattern.

Evaluation of performance characteristics of the medicinal leech (Hirudo medicinalis) for the treatment of venous congestion.

Medicinal leeches (Hirudo medicinalis) are a standard treatment for venous congestion, a complication that can occur after reconstructive surgery. If the cause of venous congestion cannot be surgically corrected, then medicinal leeches are used to temporarily increase perfusion levels and maintain physiologic requirements within the congested tissue. Leeches increase perfusion within congested tissue by actively drawing off blood as a bloodmeal.