Medicinal leech therapy on head and neck patients: a review of literature and proposed protocol

Elyassi, Ali R.; Terres, Jayson; Rowshan, Henry H.

doi:10.1016/j.oooo.2011.12.020

Cited by 31 publications

(30 citation statements)

References 23 publications

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“…Exsanguination via stab incisions, application of enoxaparin local therapy, and mechanical leeching has also been used . While use of the medicinal leech ( Hirudo medicinalis ) has been reported to successfully salvage venous congestion in free flaps, its use carries significant risks . The incidence of infection is 2.4% to 20%, most often caused by Aeromonas hydrophilia , a gram‐negative rod bacteria .…”

Section: Discussionmentioning

confidence: 99%

“…4,9,10 While use of the medicinal leech (Hirudo medicinalis) has been reported to successfully salvage venous congestion in free flaps, its use carries significant risks. 3,9,11 The incidence of infection is 2.4% to 20%, most often caused by Aeromonas hydrophilia, a gram-negative rod bacteria. 11 Patients may also experience anemia due to blood loss, although this risk is present in any therapy that involves exsanguination, including venocutaneous fistula.…”

Section: Discussionmentioning

confidence: 99%

“…3,9,11 The incidence of infection is 2.4% to 20%, most often caused by Aeromonas hydrophilia, a gram-negative rod bacteria. 11 Patients may also experience anemia due to blood loss, although this risk is present in any therapy that involves exsanguination, including venocutaneous fistula. 3 Surgical therapy for venous congestion involves anatomical correction of the vascular pedicle and exploration for geometrical issues such as kinking, hematoma, and/or thrombosis.…”

Section: Discussionmentioning

confidence: 99%

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Free flap salvage from venous thrombosis by creation of a venocutaneous fistula: Case report and review of the literature

et al. 2019

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Background Venous congestion is the most frequently reported complication of free flap tissue transfer in head and neck patient with cancer. Numerous methods are utilized and prompt correction is necessary to prevent flap failure. Methods A 77‐year‐old woman underwent oral cavity resection and neck dissection for squamous cell carcinoma followed by radial forearm free flap for reconstruction. Three days later, the flap became congested and surgical exploration revealed extensive venous thrombosis throughout the free flap venous system and internal jugular vein. The flap vein was evacuated and flowing, and a venocutaneous fistula was created thereafter. Results Venocutaneous fistula resulted in flap decongestion and successful salvage. The patient was discharged from the hospital with no further flap or surgical complications. Conclusion When anatomical revision of the venous anastomosis is not feasible in a venous‐congested free flap, the creation of a venocutaneous fistula should be considered as a viable option for salvage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Free flap salvage from venous thrombosis by creation of a venocutaneous fistula: Case report and review of the literature

et al. 2019

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“…Hirudin also acts as a bacteriostatic and bactericidal agent. 149,152 Other compounds with relevant biologically active properties (e.g., antibacterial, anti-inflammatory, vasodilation, and analgesic) include calin, destabilase, hirustatin, bdellins, hyaluronidase, tryptase inhibitor, eglins, factor Xa inhibitor, acetylcholine, and histamine like. 149 Leech therapy has been extensively employed in wound healing to remove stagnant blood from wounds after reconstruction or plastic surgery, due to the ability of leeches to absorb blood through either puncture the skin or bite, and to release therapeutic compounds (e.g., hirudin) directly into the lesion.…”

Section: Living Organismsmentioning

confidence: 99%

Traditional Therapies for Skin Wound Healing

Pereira

Bartolo

2016

Advances in Wound Care

381

235

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The regeneration of healthy and functional skin remains a huge challenge due to its multilayer structure and the presence of different cell types within the extracellular matrix in an organized way. Despite recent advances in wound care products, traditional therapies based on natural origin compounds, such as plant extracts, honey, and larvae, are interesting alternatives. These therapies offer new possibilities for the treatment of skin diseases, enhancing the access to the healthcare, and allowing overcoming some limitations associated to the modern products and therapies, such as the high costs, the long manufacturing times, and the increase in the bacterial resistance. This article gives a general overview about the recent advances in traditional therapies for skin wound healing, focusing on the therapeutic activity, action mechanisms, and clinical trials of the most commonly used natural compounds. New insights in the combination of traditional products with modern treatments and future challenges in the field are also highlighted. Natural compounds have been used in skin wound care for many years due to their therapeutic activities, including anti-inflammatory, antimicrobial, and cell-stimulating properties. The clinical efficacy of these compounds has been investigated through and trials using both animal models and humans. Besides the important progress regarding the development of novelextraction methods, purification procedures, quality control assessment, and treatment protocols, the exact mechanisms of action, side effects, and safety of these compounds need further research. The repair of skin lesions is one of the most complex biological processes in humans, occurring throughout an orchestrated cascade of overlapping biochemical and cellular events. To stimulate the regeneration process and prevent the wound to fail the healing, traditional therapies and natural products have been used with promising results. Although these products are in general less expensive than the modern treatments, they can be sensitive to the geographic location and season, and exhibit batch-to-batch variation, which can lead to unexpected allergic reactions, side effects, and contradictory clinical results. The scientific evidence for the use of traditional therapies in wound healing indicates beneficial effects in the treatment of different lesions. However, specific challenges remain unsolved. To extend the efficacy and the usage of natural substances in wound care, multidisciplinary efforts are necessary to prove the safety of these products, investigate their side effects, and develop standard controlled trials. The development of good manufacturing practices and regulatory legislation also assume a pivotal role in order to improve the use of traditional therapies by the clinicians and to promote their integration into the national health system. Current trends move to the development of innovative wound care treatments, combining the use of traditional healing agents and modern products/practices, such as nanofibers ...

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“…Giving the patient psychological and social support during this period is sometimes a forgotten but vital part of the treatment. [22][23][24][25][26][27][28][29] (Figure 19.) Figure 19.…”

Section: Troubleshooting the Flapmentioning

confidence: 99%

Getting Out of a Tight Spot in Breast Reconstruction — Salvage and Saving Techniques for DIEP, SIEA, and Lymphatic Flaps

Studinger¹

2013

Breast Reconstruction - Current Perspectives and State of the Art Techniques

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Medicinal leech therapy on head and neck patients: a review of literature and proposed protocol

Cited by 31 publications

References 23 publications

Free flap salvage from venous thrombosis by creation of a venocutaneous fistula: Case report and review of the literature

Free flap salvage from venous thrombosis by creation of a venocutaneous fistula: Case report and review of the literature

Traditional Therapies for Skin Wound Healing

Getting Out of a Tight Spot in Breast Reconstruction — Salvage and Saving Techniques for DIEP, SIEA, and Lymphatic Flaps

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