Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Hand Surg Am. 2020 Jul;45(7):638-643. doi: 10.1016/j.jhsa.2020.03.026. Epub 2020 May 31.
Venous congestion after digital replantation or revascularization threatens digit survival in the immediate postoperative period. External bloodletting, including leech therapy, provides a central role in salvage of the congested finger. Although there have been previous studies describing the initiation of leech therapy for digits experiencing venous insufficiency, few published articles and no consensus guidelines have discussed the weaning of leeches in the postoperative period. We review the current evidence behind leech therapy and offer a treatment algorithm based on available data and existing leech weaning protocols.
静脉淤血在断指再植或血运重建术后会威胁手指存活。术后早期，通过外部放血（包括使用蚂蟥）可挽救淤血手指。尽管之前有研究描述了通过蚂蟥治疗静脉功能不全的手指，但很少有文献和共识指南讨论术后蚂蟥的脱除。我们复习了蚂蟥治疗的现有证据，并根据现有数据和蚂蟥脱除方案制定了治疗算法。
