Mechanical leech therapy to relieve venous congestion.

When faced with venous insufficiency following replantation or free-tissue transfer, the surgeons' first choice is surgical repair. When repair is not possible, medicinal leeches may be applied to relieve congestion. However, leeches increase the possibility of infection through their gut contents, and there are times when the available leech supply is short and the need for rapid exsanguination is great. A mechanical device has been developed and tested which could be used as a substitute for the medicinal leech. Using a venous-congested rat epigastric flap, this device was demonstrated to be superior to a medicinal leech in restoring capillary perfusion to the flap during the first hour of exsanguination. The device may offer an alternative to the medicinal leech for the clinical treatment of small areas of tissue with venous congestion.