Leech Therapy

Leech therapy is a natural healing method and belongs to the so-called draining procedures. The leech (Hirudo medicinalis) is related to the earthworm, which belongs to the annelid family. Leeches are bred in a sterile state especially for medical purposes and can be obtained from pharmacies. The principle of leech therapy is based on local bloodletting (a procedure known since ancient times) and on the action of specific leech active substances. A certain amount of blood was taken from the patient, as it was believed that bad blood should be removed.

Indications (areas of application)

  • Diseases of the musculoskeletal system:
  • Venous diseases
    • Acute and chronic thrombophlebitis (superficial phlebitis).
    • Posthrombotic syndrome (PTS) with accompanying symptoms of congestion – refers to the effects of permanent damage to the deep venous system of the arm or leg after an expired phlebothrombosis (complete or partial occlusion of a vein by a blood clot/thrombus).
    • Congestion conditions of lymphatic vessels and veins.
    • Hemorrhoidal disease – nodular arterial vasodilatation in the area of the anus (mouth or excretory opening of the intestine).
  • Other indications

Contraindications

  • Skin diseases at the site of application
  • Hemorrhagic diathesis (pathologically increased bleeding tendency) or hemophilia (“hemophilia”).
  • Blood clotting disorders due to medication (eg, Marcumar).
  • Anemia (Hb < 10 g/dl), i.e. significant anemia.
  • Allergies to leech ingredients (hirudin, histamine, etc.).
  • Acute stomach or intestinal ulcers
  • Pronounced wound healing disorders (eg, in poorly controlled diabetes mellitus).
  • Advanced peripheral vascular disease (pAVK from stage III).
  • Gangrene – ischemic necrosis (tissue death) due to lack of blood flow.
  • Severe immunodeficiency/immune deficiency (AIDS, chemotherapy).
  • Severe chronic diseases (eg, advanced cancer).

Before therapy

  • Acetylsalicylic acid (ASA) should be discontinued seven to ten days before treatment after consultation with a physician.

The procedure

Before treatment, the patient should be informed about side effects such as wound healing disorders, scarring or hyperpigmentation (possible increased brownish coloration of the skin). Since leeches are particularly sensitive to odors and evaporation through the patient’s skin, the patient should refrain from alcohol, nicotine, medications and fragrances (e.g. perfume) prior to treatment. To stimulate blood circulation, the area (territory) to be treated is rubbed with warm cloths. The treatment should take place in a relaxed environment. The leeches are placed directly on the desired area with the help of plastic tweezers. The bite is usually not felt by the patient. Once the leeches have reached a certain saturation, they release the suction by themselves and should be picked up directly by the therapist. They must not be forcibly detached, as leaving the cartilaginous suction apparatus in the wound must be avoided.In addition, the use of saline solutions to remove leeches is unsuitable (contraindicated), as they vomit their intestinal contents in response to the stimulus (irritant), which can cause infection. Approximately 20-30 minutes after the treatment, the wounds are dressed with absorbent cotton and cellulose. If the wounds bleed heavily, the dressing is changed every hour at first, and later every 12 hours. The treatment is usually carried out over a period of half an hour to two hours. Depending on the indication and localization, the therapy is performed with about 6-12 leeches. To optimize the success, the therapy can be repeated. A leech is used only once, otherwise there would be a possible risk of infection (e.g. of hepatitis or HIV) for other patients. Leeches belong to medicinal products, which is why their handling is strictly regulated. The saliva of leeches contains more than 100 biologically active substances. The following special leech active substances are valuable components of therapy:

  • Hirudin (thrombin inhibitor) – acts antithrombotic (“directed against a thrombosis“; against the formation of thromboses), fibrinolytic (anticoagulant), immunizing, lymph flow promoting, antibiotic and diuretic (promotes urination); the local vasodilation (vasodilatation) acts spasmolytic (antispasmodic).
  • Eglin – has an inhibitory effect on proteases (enzymes that cleave proteins (protein)).
  • Bdellin – a plasmin inhibitor (plasmin is an enzyme that can break down components of blood clots).
  • Hementin – has a hyperemic effect (promotes blood flow).

Biochemical studies have now demonstrated analgesic (analgesic) and anti-inflammatory (anti-inflammatory) properties in addition to the known anticoagulant properties.

Potential complications

  • Prolonged and severe post-operative bleeding (bleeding for up to 24 hours).
  • Itchy erythema (extensive reddening of the skin) around the bite sites.
  • Wound infection (e.g., erysipelas / erysipelas).
  • Temporary joint effusion
  • Local swelling
  • Regional lymphadenopathy (lymph node enlargement).
  • Pigmentary disorders
  • Small papule (nodule) or/and scarring at the bite site.

Your benefit

Leech therapy is a proven natural healing method that is a useful complement to conventional medical treatment and therapy.