Uses of Leech Therapy in Patients with Skin Grafts

Leeches, as we all know, can be viewed by many as quite disgusting creatures to look at, especially when they are full and bloated after gorging themselves on blood. Many people fear leeches and most stay away from them. Just the thought of having a leech attach themselves to a part of the body is enough to scare anybody. But remember, there are leeches that serve many purposes, especially when it comes to the medicine world. These medicinal leeches have long been used in the treatment of illnesses and diseases, and they have also been used in the healing process of skin grafts.

What is a Skin Graft?

When a patch of skin is taken from the same individual and transplanted to another part of their body, it is called skin grafting or skin transplant. The patch of skin taken from an individual is removed from an area of the body that has good circulation to increase the chance of healing quickly and properly. Common areas where skin grafts are taken are those that are hidden underneath clothes, usually from the buttocks or inner thighs. After skin harvesting, the donor site is covered with sterile and non-adhesive dressing so as to prevent the occurrence of infection.

After the patch of healthy skin is harvested, it is carefully spread over the required area. To keep it in place so as to promote good healing and good revascularization, well-padded dressings that exert gentle pressure are placed over the skin graft. Stitches can also be used to keep the skin graft in place to allow growth of new blood vessels, supplying the transplanted skin with blood, thus, increasing the healing process.

Skin grafts, although taken from the same individual, can still present a lot of risks. Infection of the recipient site can occur and delay healing and complications can also arise such as poor venous drainage leading to skin graft tissue death, and this is most especially true for patients whose vascular system is compromised.

If this occurs, skin grafting can be repeated in the hope that the graft will be successful the next time, but nowadays, many surgeons use leeches to avoid the above from happening.

Why Use Leech Therapy?

Leech therapy has been used for many years as a treatment for many conditions, especially when it comes to infection, so studies were done and it has been found, tested, and proven that leech therapy can really aid in the healing process of skin grafts.

How does Leech Therapy Promote Healing and Recovery of Patients who have Undergone Skin Grafting?

As soon as the leeches attach themselves to the skin graft site, they begin to suck blood. While sucking, they also release a component called hirudin from their saliva. This component is very important in the inhibition of platelet aggregation (the process where the platelets clump or stick together) and coagulation cascade (a series of processes that ends with fibrin clot formation).

If these two detrimental complications are present in a skin graft, there will be marked venous congestion, which slows down the healing process of the skin graft. When the skin graft receives poor circulation, the site becomes cyanotic [a condition in which the skin and mucous membranes take on a bluish colour because there is not enough oxygen in the blood], then it hardens and cools until the transplanted tissue dies. Now, because of the hirudin and the Factor Xa inhibitor present in the leech’s saliva, these processes are inhibited. Since there is a vasodilator component in their saliva too, venous congestion is further reduced, promoting good blood flow into the skin graft. After continuous medicinal leech therapy, the skin graft will soon turn warm and pinkish, a good sign that there is an adequate blood supply.

Frequency of Leech Therapy in Patients with Skin Grafts

Medicinal Leeches suck on the area for up to an hour or more, where they can consume one to two teaspoons of blood. Two days after leech therapy, the skin graft site will show a noticeable increased blood supply to the area.

The frequency of leech therapy in patients with skin replants is about four days to five days, while the frequency in patients whose skin grafts became compromised is about six to ten days.

Leech Therapy Contraindications

Not all patients who undergo skin grafts are a candidate for leech therapy. Those who have AIDS or HIV are not recommended to undertake medicinal leech therapy because it could put them at risk of bacterial sepsis. Likewise, patients who take immunosuppressive drugs are also not advised to undergo leech therapy due to the same reason.

Although the risk of acquiring an infection is small, patients with skin grafts that have become unsuccessful are not always given leech therapy.