Medicinal leeches (Hirudo medicinalis) may be helpful in reducing vascular congestion following traumatic injury or surgery. However, their use can be complicated by a number of adverse effects.


Infectious complications:

(1) infection with Aeromonas or other water-related Gram-negative bacteria

(2) transmission of HBC, HCV or HIV if the leech is reused for more than one patient


Noninfectious complications:

(1) allergic reaction to leech secretions

(2) anemia

(3) migration of the leeches into body cavities

(4) psychological distress in patients, family or health care workers

(5) triradiate skin scar


Complications can be reduced by:

(1) purchasing leeches from reputable sources (? leech ranchers)

(2) prophylactic antibiotic therapy with a third generation cephalosporin

(3) education with informed consent

(4) adherence to an institutional protocol


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