Leeches, sneeches-- oh my!

[bumpkittynurse]

I'm looking for info/advice on working with medicinal leeches. I had a patient with an auto-skin graft with some venous congestion/necrosis, and the leeches were ordered for the congested areas. So...

How do you get a leech to move without harming it? I used a little salt to get it unstuck, cleaned off the salt and then tried re-directing it. It was very fast and stubborn about going for new tissue-- it wasn't going for the surface blood on the target area, and i tried to use a #26 needle to stimulate an area of blood flow (decreased sensation on the graft, pt couldn't feel it), but that didn't work. Is there anything else they like that will get them to stay in one place? What are some good materials to use that won't hurt them? I used moistened sterile 4x4s.

What can you use for a border to keep them from wandering? I used some damp kerlix, but I was concerned about macerating surrounding tissue-- and then one got loose in the sheets anyway.

And when you're getting them out of the container and they grab on to the jar-- what do you do?

Safety issues re: the suckers when they've got pt blood in them? Ever hear of them getting inside incisions/orifices?

What are other things they're used for?

Any good tips on relieving patient anxiety about the treatment?

Thanks everybody-- it's been hard to find good info outside of our institutional protocol, which is short on practical tips.

[TazziRN, RN]

I've only seen one pt with leech therapy. I was so interested I asked the doc some questions. I remember he told me leeches don't like to be moved from the dinner table, so if you need to move the leech to a new site it's better to get a new one. He also said that leeches don't let go until they're full, so if you've got wandering leeches it might help to check on them more frequently.

Pt anxiety: tell them that leeches have been used for centuries.

[Athenas83]

In what specialty are leeches used so I can stay away? I'm squeemish when it comes to creepy crawlers. Of course, if I was called to duty I'd get the job done...but wow.

[coolvibesRN]

In what specialty are leeches used so I can stay away? I'm squeemish when it comes to creepy crawlers. Of course, if I was called to duty I'd get the job done...but wow.

Same here.

[NRSKarenRN, BSN, RN]

ce course with great info nurse.com - leech therapy

[anc33]

When I worked on the floor we used leeches fairly often. It would be funny to go to the unit's fridge and see a milk jug full of them. The patients actually seemed to like them! But yeah, once they grab on it is tough, if not impossible, to get them to move.

[CHATSDALE]

maggots and leeches the more things change the more they stay the same

leeches have a anticoagulent in their salvia the they are used on gangrenous areas in an attempt to same the limb [that was where i have seen them

both the maggots and the leeches had to flown in because they was none available locally..did not go over well with the family members

can't figure out why lol

[TazziRN, RN]

The doc I knew used them to encourage healing in fingertip amputations and avulsions, since it's very common to lose the tip because of circulation issues.

[RNperdiem, RN]

I have used leeches occasionally in plastic surgery patients where there is a flap graft of tissue. Sometimes there is poor venous outflow from the graft, this can destroy the graft if left untreated. The leeches remove the excess blood. These leeches are specially ordered medical leeches.

The first trick is trying to detach the leech from your glove when you pick one up. You pull on the leech, and it will stretch like silly putty before letting go.

Be sure to watch the leech carefully. I work in ICU, so this is usually not a problem. You don't want the leech crawling into the ear or a trach.

When the leech is fat and happy, they detach easily and are dropped in a cup of rubbing alcohol.

[anc33]

The first trick is trying to detach the leech from your glove when you pick one up.

Never tried picking them up by hand, always used forceps. Must feel pretty weird to have one latch on.

[MikeyJ, RN]

In my "Intro to Nursing" class last year, my professor had a nurse entrepreneur come in and speak to us. She opened a medical leech business where she breeds leeches and then sells them to hospitals and clinics all around the country. She said she has become very successful at it. I forget the name of her company -- something along the lines of American Medical Leech Co. or something similar.

[Wise Woman RN]

Eeew...