Acta Chir Plast. 2020 Winter;62(3-4):95-102.
Medicinal leeches (Hirudo medicinalis, Hirudo verbana) have been used in the field of medicine to treat various diseases for thousands of years. Popularity of their use changed over time and in Europe, it peaked at the beginning of the 19th century. In modern medicine, application of leeches on flaps with venous congestion was first used and described by Deganc and Zdravic in 1960. A certain renaissance of leech use is currently taking place, especially in the field of reconstructive surgery. In general, use of leeches is indicated during critical post-operative period, in which the microcirculation and veins are incapable of sufficient drainage of venous blood, which can lead to stagnation of circulation in tissues at all levels, clinically manifested as a change in color and turgor of the flap. If this venostasis is not recognized in time and treated adequately, tissue necrosis can develop. Medicinal leeches can be used in venous drainage disorders after a replantation of fingers, auricles, lips and parts of the nose. In head and neck reconstructive surgery, there are many studies that confirm the success rate of hirudotherapy in hematoma evacuation or in dealing with complications after scalp replantation and transfers of free and pedicled flaps. Leech application therapy can also be indicated as a part of non-surgical methods that improve conditions of the venous system.
医用蛭类（医用水蛭、宽体金线蛭）作为药物治疗各种疾病已有数千年的历史。随着时间的推移，它们的应用变得越来越受欢迎，在欧洲，这种情况在 19 世纪初达到顶峰。在现代医学中，Deganc 和 Zdravic 于 1960 年首次应用和描述了在带有静脉充血的皮瓣上使用水蛭。目前，蛭类的应用正在复兴，尤其是在重建外科领域。一般来说，在关键的术后期间，需要使用水蛭，此时微循环和静脉无法充分排出静脉血，这可能导致各级组织的循环停滞，临床上表现为皮瓣颜色和肿胀的变化。如果不能及时识别和充分治疗这种静脉充血，就可能发展为组织坏死。医用水蛭可用于手指、耳廓、嘴唇和部分鼻子再植后的静脉引流障碍。在头颈部重建手术中，有许多研究证实了水蛭疗法在血肿清除或头皮再植和游离及带蒂皮瓣转移后并发症处理方面的成功率。水蛭应用疗法也可以作为改善静脉系统状况的非手术方法的一部分。
