Are leeches effective in local/regional skin flap salvage?

Welshhans, Jamie L.; Hom, David B.

doi:10.1002/lary.25855

Cited by 8 publications

(1 citation statement)

References 5 publications

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“…Intraoperatively, the use of topical anticoagulants is associated with increased survival of replanted digits, skin grafts, and flaps during free-tissue transfer [24]. Perhaps the oldest anticoagulant, the leech Hirudo medicinalis has proven efficacy in reducing venous congestion of skin flaps in plastic surgery, thereby preventing loss of the flap [25,26]. The secret to the leech’s success is its secretion of hirudin, an inhibitor of thrombin.…”

Section: Introductionmentioning

confidence: 99%

Local Pro- and Anti-Coagulation Therapy in the Plastic Surgical Patient: A Literature Review of the Evidence and Clinical Applications

et al. 2019

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The risks of systemic anti-coagulation or its reversal are well known but accepted as necessary under certain circumstances. However, particularly in the plastic surgical patient, systemic alteration to hemostasis is often unnecessary when local therapy could provide the needed adjustments. The aim of this review was to provide a summarized overview of the clinical applications of topical anti- and pro-coagulant therapy in plastic and reconstructive surgery. While not a robust field as of yet, local tranexamic acid (TXA) has shown promise in achieving hemostasis under various circumstances, hemostats are widely used to halt bleeding, and local anticoagulants such as heparin can improve flap survival. The main challenge to the advancement of local therapy is drug delivery. However, with increasingly promising innovations underway, the field will hopefully expand to the betterment of patient care.

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Section: Introductionmentioning

confidence: 99%