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.
learn aboth maggots, leaches, honey bee and fish therapy:
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Hirudis Medicinalis if my memory is correct, are a take it or not assignment. There were only a few on my unit who did the leech thing. I have seen them burrow completely into the tissue, that's why you have to document often that they are sighted. Our's came from the pharmacy in a plastic screw top jar with only a tiny bit of their home water.If I remember correctly a qtip and a tilt of the jar worked fine. When they are sated the same jar with ETOH and a qtip removed them. I don't remember if we flushed them or returned in the needle containers as hazardous waste.
Specializes in med surg, oncology, outpt and hospice.
:uhoh21: I worked on a surg/onc floor where some of the plastics doctors used leeches on grafts that were not healing right or something like that. I am VERY SQUEMISH about creepy crawleys. I could not do it. Infact I came into to work one day and was to have a leech therapy pt. I told them I would not do it and since I had not gotten report yet I would quit right now if the charge nurse insisted I had to. They tried to talk me into it:trout: but I stood firm and got another assignment. I apoligized but i did not give in:nono: . So for those of you who can do it my hats off to you:biere:
I totally agree. The slimey things don't bother me at all, but I HATEE eyes! I'd take a post op trauma or total joint over an EYE any day. There is nothing to be ashamed of not liking brother Hirudis. I didn't care for him in the African Queen either.
I work on a plastic surgery floor, and have only had one patient with leeches so far (in 10 months). I knew they had started them, but the patient had dealt with them for a couple of days before I got there. There I am with my gloves and my tweezers (from a suture removal kit), and I said flat out, "If one of those gets on me, I'm gonna freak out. I'm just warning you right now." The patient had a good laugh. And that's the important thing, right?
I've used them on the burns unit I worked at with grafts that looked like they might fail.
ALwayed used forceps to pick them up and put them onto the affected area, they usually latch on and only release when they are fully fed (ughh) We used to do regular obs on our leech patients as if they were post ops just to monitor where the leech was.
Usually the patient would let us know with a big squeal when they released.
Didn't like them as I don't do crawly squeemy things but they were very benificial. In fact I think that we have a medical leech and maggot farm quite close to where I live
I've used them on the burns unit I worked at with grafts that looked like they might fail.
ALwayed used forceps to pick them up and put them onto the affected area, they usually latch on and only release when they are fully fed (ughh) We used to do regular obs on our leech patients as if they were post ops just to monitor where the leech was.
Usually the patient would let us know with a big squeal when they released.
Didn't like them as I don't do crawly squeemy things but they were very benificial. In fact I think that we have a medical leech and maggot farm quite close to where I live
We do alot of grafts on my floor, but we use vacs with them almost exclusively. How do ya'll do it? I understand things are alot different in the UK, and leeches and maggots are alot more accepted. Also, we're just starting to use Recell skin grafts, but I've heard they are used over there alot. What do you think?
We do alot of grafts on my floor, but we use vacs with them almost exclusively. How do ya'll do it? I understand things are alot different in the UK, and leeches and maggots are alot more accepted. Also, we're just starting to use Recell skin grafts, but I've heard they are used over there alot. What do you think?
It was quite a long time ago, when I typed my first post I would've sworn it was only a couple of year ago I left so I sat here and worked it out so now I feel really old :uhoh21: I left burns in 2000 but the girls that I used to work with still use the leeches and maggots. Not too sure about the skin grafts but I can see if I can find out.
about creepy crawleys. I could not do it. Infact I came into to work one day and was to have a leech therapy pt. I told them I would not do it and since I had not gotten report yet I would quit right now if the charge nurse insisted I had to. They tried to talk me into it:trout: but I stood firm and got another assignment. I apoligized but i did not give in:nono: . So for those of you who can do it my hats off to you:biere:
clee1
832 Posts
One word: NASTY!
Sorry, but I don't do bugs.