What it is: Hirudotherapy (Leech Therapy) is a treatment using medicinal leeches. Hirudo medicinali, have been used to treat patients for centuries. In the past, leeches have proved to be an effective treatment for a number of conditions including battle wound treatment. Currently leeches may be used to assist in the treatment of abscesses, arthritis, glaucoma, myasthenia gravis, thrombosis and some venous disorders.
Medical leeches may also be used in plastic surgery and in some blood circulatory problems. During feeding, leeches secrete a complex mixture of different biologically and pharmacologically active substances into the wound. Hirudin is the prominent constituent of leech saliva. It is sometimes used to describe all the active constituents in the leech saliva.
How it works: Before applying a leech, I will ensure that the skin is washed with soap and rinsed with sterile water. Residue should be wiped away before the leech is applied because heparin will repel it. Wearing non-sterile gloves, I will use a pair of long non-toothed tongs to extract a single leech from the container. This is easier to do immediately after taking the container out of the refrigerator when the leeches are relatively docile. The leech is then placed onto the skin to the area which requires treatment. To prevent leech relocation, and to reassure the patient, dampened gauze swab can be used to restrict movement.
If the leech will not attach, pricking the skin to produce a blood droplet will usually encourage attachment. Once attached, the leech will feed for approximately 30 – 60 minutes before detaching. Each leech will be used only once and is then humanely disposed of. After therapy, a leech bite will bleed for around ten hours. During this time, the skin should be washed regularly to remove formative blood clots. Regular observation of the treatment site is mandatory; colour and appearance of the tissue, presence of pulses and clinical response should be recorded. The process is used to treat the following medical problems:
- Vascular problems such as varicose veins
- Hemorrhoids
- Deep vein thrombosis and peripheral arterial occlusion
- Skeletal system diseases such as arthrosis and arthritis Various skin diseases particularly eczema and psoriasis
- Eye diseases
Clinical trials suggest that leech therapy is an appropriate treatment for the common joint disease osteoarthritis. The anti-inflammatory and anaesthetic properties in the leech’s saliva reduce pain and tenderness at the site of the affected joint. People with anaemia, blood clotting conditions, or compromised arteries are not candidates for leech therapy. Children under the age of 18 years old and women who are pregnant are also usually advised to avoid it.
Sourcing and storing leeches: I will be purchasing the medicinal leeches from online wholesalers such as https://www.medicalleeches.com. They will be shipped in water using a specialised container and kept at a temperature of 4–5C. Gel may be used instead of water to transport them, but this should be for short-term use only (two days maximum).
When storing leeches, I will ensure to place them in a clean glass or plastic container with normal tap water. Leeches will stored in a refrigerator or cool dark place before being used. I will avoid temperatures above 20C and leeches will never be placed in direct sunlight. After every use, leeches will be destroyed by immersing them in a solution of 70% ethanol for 24 hours. They will be disposed of as bio hazardous waste. I’m aware that leeches should never be reused, even on the same patient.