Leech therapy

I work on a peds floor for post surgical and trauma patients. We occasionally have kids on leech therapy, for traumatic injuires. I don't mind it, but it can be traumatic for the patient. They are premedicated with ativan if needed. Most of them opt not to look, then they do ok.

- You get a large plastic container of leeches (the leech motel). Keep a weight on the lid, or they will get out!

- You have to isolate the area you want the leech to clamp on to. The problem is that they go for the best perfused area they can find, but you want them to clamp on to the grafted or reattached area, which is less perfused. It helps to cover the surrounding area with gauze or a glove to discourage this. You use tweezers to guide the leech, and sometimes you have to repostion it a few times before it latches on.

- I had another nurse tell me you can take a catheter tipped syringe and put the leech inside it to control where it latches on better (otherwise it will feel around with its tail for other spots). I haven't had a chance to try this, but it sounds like a good idea - less traumatic for the pt, also.

- You have to staff up for it. It's very time intensive. You have to be in the room with the patient the whole time.

- After a leech is done feeding its engorged. You pull it off and put it in a cup of rubbing alcohol, where it immediately explodes (bright red)

You have never seen everything.....

I know this therapy can be very beneficial, but I just don't think I could do it. I just about have a heart attack if I pass a leech on the sidewalk, lol

I have seen them used on re-attached limbs to help reestablish blood flow in the limb. They also use maggots in hard to heal wounds...they eat only the dead tissue/flesh and then are removed. It helps with the wounds that won't heal. Gross, yes. But I'd do it in a minute if it would help.

It is an EXCELLENT tool for trauma patients.

I've assisted twice in placing leeches on limb reattachments and it was FASCINATING.

I got to see this done when I was a PCT & got floated to an ortho floor. Very interesting. Made it worth being floated. It didn't seem all that gross to me at the time. I don't like bugs either. These things look more like worms than bugs, but they move a lot faster. It really was worth it to see how they benefitted the pt's reattached fingers.

:paw:

We used leech therapy for a patient who required a muscle flap following an extensive mastectomy due to advanced breast cancer. It worked out really well for her. She had Ativan PRN and just looked away whenever she had to. We kept a close watch on the leeches so that we could quickly collect them once they finished and detached. It's quite interesting having leeches loose in a patient's bed linens! They're quicker than you think.

I have used leeches with patients who have had plastic surgery involving flap placements. If the venous outflow is poor, I have seen leeches used to improve outflow.

Leeches remain rare where I work.

I thought leeches were fun to work with, they do tend to suck on to your glove, then you try to pull them off and they stretch.

I overheard a resident mutter once " I went to med school for 4 years to become a leech wrangler".

I saw it one time when I was in nursing school. fascinating stuff. A women had been in some machine accident and several fingers were cut off so leech therapy was used on her fingers. She named them all :) It worked!

I have seen them used most often with finger reattachments when they do now want the suture site to develop a hematoma, thus cutting off blood flow distal to the suture site. I have also seen this used around the suture line with plastic surgery. These are sterile medical leeches and have been used for ages for this type of thing and they work very well.

Maggots are a great way to clean out a wound. We used to have patients come into the ED with maggots in their wounds and although they seem gross, the wound did not smell so bad as those wounds where the maggots were not present.