leech therapy

I had the interesting task of participating in leech therapy this weekend. My patient had an accident and crushed his right hand. Circulation was a concern. The leeches were shipped in from a leech farm. They all had names beginning with "L". Louie Leech, Loretta Leech.

I watched the PA do the first treatment. The most painful part was when the patient's thumb had to be poked with a 18 ga needle to "bait" the hungry leech. I had a difficult time getting my leech to attach! Anyone else had experience with leeches?

I have had a fair amount of experience. You see it in some facial plastic surgeries and in microvascular surgery....as that was what was involved in your case. I had a had reattachment case too. It failed, the surgeon forgot to wash off the betadine and the leaches would not attach.

A big disappointment for the surgeon,

and the patient of course.

It is really gross the first time....the patients get used to it faster than the nurses applying the little boogers. Ours came from a special facility in florida that raised them for medical use, they were ordered as needed and the pharmacy dispensed them.

It was a teaching hospital. good luck with your "blood suckers !"

I've had experience. Mostly with finger surgery. Where I am though, the MD's are the ones that apply the leeches and the nurses just dispose of them (in an alcohol vial) when they fall off. I've noticed that dressings are always applied after a leech therapy. we are to soak this dressing in heparin solution to prevent coagulation of the "feeding site". really weird. Cool though!

Was actually looking for tips on leech therapy, but I'll add a few things I learned. This patient had a hand crush injury that required a vein graft, compromising circulation to all 4 fingers. The nails were removed in the initial surgery, and heparin-soaked pledgets were used EVERY 2 HOURS!! The poor patient was a light sleeper, and hardly slept at all for about a month. Anyway, the pledgets weren't quite doing the job, so they started him on leeches to relieve the venous congestion -- his fingers were purple and very engorged. TIPS:

1. Keep track of how many leeches you put on, and how many you take off. Nothing like finding a leech in the bed.

2. The time a leech spends sucking is only a small part of their therapy, according to my reading. Their saliva has anitcoagulants and such that keep the wound bleeding for several hours more.

3. According to my patient, who had watched some special on leech therapy, the leeches will not reattach once they have been pulled off. It messes up their mouths or something.

4. The patient came up with this one, too. He only needed the leeches on his index and small fingers, not on the middle two. But the leeches prefer new/good blood. So he finally wrapped his two middle fingers in gauze (like a 2x2). Took care of that problem.

5. This patient also had Xeroform (a type of medicated petroleum gauze) on the dorsum of his hand. The leeches did not like to attach through this greasy layer, so wash it off.

That's all for now. I'll try to ask some of the more experienced nurses on my floor if they have tips.