The use of leeches for treatment of venous congestion of the nipple following breast surgery

• Published in: Aesthetic plastic surgery Vol. 16; no. 4; pp. 343 - 348
• Main Authors: GROSS, M. P, APESOS, J
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01-12-1992
• Subjects: Adult; Animals; Biological and medical sciences; Bloodletting; Female; Humans; Leeches - physiology; Mammaplasty; Medical sciences; Nipples - blood supply; Postoperative Complications - therapy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Time Factors; Human; Postoperative; Mammilla; Venous incompetence; Annelida; Case study; Mammary gland diseases; Treatment; Surgery; Hirudo medicinalis; Complication; Hirudinea; Technique; Invertebrata
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/BF01570698

The medicinal leech, Hirudo medicinalis, played a central role in the evolution of medieval and folk medicine. Today, for the first time in history, the leech actually has a real and valuable purpose in medicine as a useful adjunct for the plastic surgeon: It provides relief of venous congestion. For over 2000 years, leeches were needlessly applied for a multitude of maladies as an adjunct to blood-letting. Their use in Europe peaked between 1830 and 1850, however, shortages led to a subsequent decline in leech application. Today there is a real clinical use for leeches which had led to a resurgence in their use in plastic surgery. Plastic surgeons use leeches in microsurgery to salvage congested flaps, whose viability is uncertain due to venous congestion. We present our experience with two patients where leeches were used to treat isolated venous engorgement of the nipple following breast surgery. Leech therapy is painless, well tolerated, and does not result in significant scarring. Prompt initiation of treatment is mandatory and produces dramatic resolution of venous congestion.