Plastic and replantative surgery

Already from the 18ten to century report from France exists over the use of leeches with the transplantation of skin rags.

At the surgical hospital of Ljubljana the leech therapy does not only belong already for a long time to the standard treatment with Thrombose and Phlebitis.

"venous congestions and following Thrombose is the feared and most serious complication with skin rags and Rollappen. Necrosis occurs, in the following infection and Sepsis. The haemodynamische imbalance, which results in venous insufficiency, is to be recognized to "blue flap". The normal measure is the decompression by partial distance of the seams, emptying a Haematoms, various point ions, which is under it, Skarifikationen and small Inzisionen, which remain mostly unsuccessful however. The skin rags can be saved however often only by partial Resektion. For the treatment of the Venostase in skin and Rollappen in Ljubijana 1955 leech were used for the first time. Encouraging results would have shown up with nearly all treating patients. To to most kongestiven place 3-6 leech are set. One lets it suck, as long as they want, and permits for an unlimited period the postoperative hemorrhage, 24 or also 48 hours long. Two or three times the procedure is repeated. The Dekongestion can be observed clearly and also still hours later, if leech are set to the correct place, before the cycle disturbance is irreversible. One determined a complete re-establishment of the circulation with 70%, partial with 30% de Faelle and experienced no Sepsis.

According to shopkeeper the leech therapy became lively in the eighties in the plastic and rekonstruktiven surgery of Upton in the USA and of Mahaffey in Europe. "Leeches possess properties that make them uniquely able tons assist with venous compromised tissue". leech were used at many surgical centers of the whole world and could retain transplants, which would not be to be saved in other way. Mostly Hirudo medicinalis one use.

The improvement of the bloodstream was objektiviert by Hayden by doppler laser investigations. Anthony proved fluorimetrisch that the arterial influx decreases improved and the venous Kongestion. Lee secured the use in the animal experiment. With rats in each case two epigastrische skin rags were formed and exposed to a venous okklusion by six hours. Then randomized on a rag of the leech one set, while the second rag served as control. Survivor the skin area became significantly larger under blood yellow action. Smoot confirmed likewise that the leech exceed other techniques for the re-establishment of the blood river.

Beyond the Hauttransplantation the blood yellow action was praised particularly with the Replantation of separated fingers (e.g. case studies of Baker, golden). Apple mountain reports on the leech"to illustrate the fantastic array OF modalitiesavailable ton of plastic surgeons for to major resections and reconstructions." Largely the dramatic solution of venous Kongestionen stresses and praises the Schmerzlosigkeit of the procedure, that is well tolerated and not in important scar formation ends." (1)

1) Dr.med Ingo William Mueller - manual of the leech therapy (2000)