Rothenberger Jens, Petersen Wiebke, Schaller Hans-Eberhard, Held Manuel
Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany.
Wound Repair Regen. 2016 Nov;24(6):1023-1029. doi: 10.1111/wrr.12491. Epub 2016 Nov 2.
A universal protocol determining the number of leeches and their application time does not exist. The aim of this study, therefore, is to quantify perfusion dynamics in venous congested tissues after leech application to get more detailed information about changes due to leech-induced skin microcirculation and to evaluate the usability of the Oxygen to See (O2C) device in terms of determining the appropriate number of leeches and the duration of therapy. Twelve patients with the need for leech therapy participated in the study. Perfusion dynamics of the congested tissue was assessed using the O2C device, which determines blood flow (BF), the relative amount of hemoglobin (rHB), and the oxygen saturation (SO2). Measurements were carried out before leech application and on various intervals like 10 minutes, one hour, and three hours after leech application. The leech application effectuated after 10 minutes a nonsignificant perfusion improvement, which further increased after one hour with a significant reduction of the relative amount of hemoglobin and a significant increase of blood flow and oxygen saturation (BF= +56.7%; rHB= -25.5%; SO2= +53.7%). After three hours, the values returned to the levels before leech administration. In two cases, in which further administration of leeches within the measurement period was necessary, no substantial perfusion changes were obtained. The results of this study forms a more precise pattern of microcirculatory changes of leech therapy in congested tissues. According to our measurements a venous drainage improvement can be expected in congested tissue one hour after leech administration. The O2C seems to be a useful method to determine the appropriate number and duration of leech therapy.
目前尚无确定水蛭数量及其应用时间的通用方案。因此，本研究的目的是量化水蛭应用后静脉充血组织中的灌注动力学，以获取更多关于水蛭引起的皮肤微循环变化的详细信息，并评估“氧可视（O2C）”设备在确定水蛭合适数量和治疗持续时间方面的可用性。12名需要水蛭治疗的患者参与了该研究。使用O2C设备评估充血组织的灌注动力学，该设备可测定血流量（BF）、血红蛋白相对含量（rHB）和血氧饱和度（SO2）。在水蛭应用前以及应用后10分钟、1小时和3小时等不同时间间隔进行测量。水蛭应用10分钟后灌注有不显著改善，1小时后进一步增加，血红蛋白相对含量显著降低，血流量和血氧饱和度显著增加（BF = +56.7%；rHB = -25.5%；SO2 = +53.7%）。3小时后，各项数值恢复到水蛭应用前的水平。在两例测量期间需要进一步应用水蛭的病例中，未观察到明显的灌注变化。本研究结果形成了水蛭疗法在充血组织中微循环变化的更精确模式。根据我们的测量结果，预计水蛭应用1小时后充血组织的静脉引流会得到改善。O2C似乎是确定水蛭疗法合适数量和持续时间的有用方法。
