Before we explore the downsides to leech therapy we need to better understand when it is used and why. Doctors usually employ leech therapy to treat blood clotting in patients who have undergone reconstructive surgery, whether it be skin grafting or reattachment of a limb. Skin grafting is a procedure where the doctor removes an area of skin so that it can be put elsewhere on the body. It is often performed in cases of burns or large wounds, and the most common complication is pooling of the blood in injured tissues. Leech saliva contains an anesthetic that numbs the wound area and an anticoagulant substance called Hirudin that stops blood flow. These properties ought to make leeches a prime candidate for treating blood congestion, but there is more to the story.
Complications sometimes emerge when using leech therapy in treating both reconstructive surgery and osteoarthritis, prompting the need for further research to prevent future problems. Doctors primarily use leeches in reconstructive surgery when blood congestion causes the wound to swell, but bacterial infection of the wound often causes complications. After reconstructive surgery the leech must be transferred from its water tank onto the site of the wound. The leech then does its job of bloodletting and is discarded afterward. Even with a sterile environment, bacterial infection can still develop. Leeches contain a bacterium called Aeromonas in their gut so that they can digest red blood cells. Presumably leeches can directly inject this organism from their mouth onto the wound, or water from where the leech was stored might accidentally contaminate the wound. Infection can initiate further complications such as necrosis of the skin graft; put more simply, the graft fails and the skin begins to decay. Although doctors often successfully resolve these cases, in some studies, infection rates are as high as 20%. Until scientists unearth a foolproof way of preventing them, we shouldn’t rely on leech therapy as a primary treatment for blood pooling.
A less dire trouble with leech therapy is the false marketing of medicinal leeches. In 2004, the FDA approved the use of the species Hirudo medicinalis in skin grafting. However, a study conducted in 2007 proved that some leeches that European companies labeled as Hirudo medicinalis were actually Hirudo verbana. Regardless of whether this would make an effective difference when treating blood clotting, the FDA has only approved medicinal use of the species Hirudo medicinalis. Mislabeling leeches could even set a precedent that accepts such dishonest conduct, potentially encouraging European markets to harvest the cheapest species of leeches in order to increase profits. Although incorrect identification of leeches hasn’t yet caused any adverse reactions in the medicinal use, the possibilities are enough to warrant action. Before we should use leeches in medicine, we need to settle false marketing to avoid crisis.
A leech's species can be hard to identify, but that doesn't warrant false marketing.
Clearly leeches can effectively resolve blood congestion, but an issue lies in the storage and transportation of them. Leeches require a 60 degree temperature and shouldn’t be exposed to direct sunlight or fluorescent light. They also need certain size air holes in order to prevent escape. Because in most cases leeches are needed in an emergency situation, transport from the marketers to the hospital must be carried out in a brief fashion. Not much can change the specific conditions in which leeches must be stored and shipped, yet we should still consider it when deciding whether leech therapy is the best method of treating blood congestion.
Studies regarding the effectiveness of leech therapy in osteoarthritis patients highlight the importance of the placebo effect. The placebo effect occurs when patients try out a treatment, and they improve simply because they believe the treatment will work. In a 2008 experiment, patients were divided into a control group and a treatment group. Treatment group patients improved more so than control group patients and felt less pain at the end of the treatment, but the placebo effect wasn’t fully factored out. Doctors gave control group patients a pseudo leech, but it couldn’t fully simulate a real leech. Because of this, only one fifth of the control group believed they were given a real leech. The progress seen in treatment group patients could have been from the leech saliva or treatment procedure, but the placebo effect could also have made an improvement. To better understand the true efficacy of leech therapy in osteoarthritis patients, we should conduct more experiments. Leeching should also be tested against other more common treatments for osteoarthritis, such as anti-inflammatory drugs.
Even if there were fewer of the aforementioned complications with leech therapy, we couldn’t justify using leeches if another treatment were more effective and better satisfied the patients. A study in 2010 compared the use of leech therapy and another form of treatment, venous catheterization. Venous catheterization involves inserting a tiny tube into a vein. In this case, the tube would suck excess blood out of the site of the wound. Doctors randomly divided the patients into two groups and gave them one of the two treatments. Patients who were given the venous catheterization treatment had better results across the board. This treatment removed more blood by volume; a smaller percentage of patients had complications including infection, wound breakage and flap necrosis. In addition, patient satisfaction on average was higher in the venous catheterization than in the leech therapy. The conclusion is simple: one treatment was more effective and provided better results than another. If a more effective alternative treatment than leech therapy exists, patients should choose that one. We should conduct more comparative experiments in order to test other alternatives against leech therapy.
People may be more inclined to accept leech therapy as a treatment for blood pooling due to nostalgia for an ancient technique, but ultimately the best treatment is the one that patients should choose. Scientists need to do more research on leech therapy in order to prevent infection and other problems and prove it as the best treatment method before encouraging the use of leech therapy.
Works Cited
"Suckers for success: The use of leeches is making a comeback, and not just in medicine." Nature: International weekly journal of science. 484.7395 (2012): Web. 18 Sep. 2012.Asplund, L. “The leech therapy wave. They've proven their worth, but stocking them isn't easy.” Materials management in health care. 10.4 (01 Apr 2001): 35. American Hospital Pub. 18 Sep 2012.
Mozafari, N., Ghazisaidi, M. R., Hosseini, S. N. and Abdolzadeh, M. “Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap.” Microsurgery. 31 (2011): 36–40. 18 Sept 2012.
Haycox, Claire, Marc Coltrera, Gregory Raugi, and Peter Odland. "Indications and complications of medicinal leech therapy." Journal of the American Academy of Dermatology. 33.6 (1995): 1053–1055. Web. 18 Sep. 2012.
Andereya, Stefan, Sven Stanzel, Uwe Maus, Ralf Mueller-Rath, Torsten Mumme, Christian Siebert, Friedrich Stock, and Ulrich Schneider. "Assessment of leech therapy for knee osteoarthritis: A randomized study."Acta Orthopaedica. 79.2 (2008): 235-243. Web. 18 Sep. 2012.
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