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Sell the rights SR-EL. We accept all major credit cards from Finland. Log In Sign Up. Hirudo medicinalis and the plastic surgeon … journal of plastic surgery, Iain Whitaker. Hirudo medicinalis and the plastic surgeon. Izadib, D. Oliverc, G. Monteathd, P. The popularity of Hirudo Medicinalis has varied medicinalis; Post- throughout history, reaching such a peak in Europe in the early 19th century that operative; Flaps; Current supplies were exhausted.
During the latter half of the 19th century, their use fell out of practice; UK favour, as they did not fit in with the emerging concepts of modern medicine.
Hirudo Street [Peter Dolan] on lirodisa.tk *FREE* shipping on qualifying offers. In the summer of , Julius Genachowski, the Chairman of the Federal. Editorial Reviews. About the Author. Peter Dolan spent ten years as a stockbroker at two of the Hirudo Street - Kindle edition by Peter Dolan. Download it once and read it on your Kindle device, PC, phones or tablets. Use features like bookmarks, note.
Leeches have enjoyed a renaissance in the world of reconstructive microsurgery during recent years, and their first reported use in alleviating venous engorgement following flap surgery was reported in this journal [M Derganc, F Zdravic, Venous congestion of flaps treated by application of leeches, Br J Plast Surg 13 ] . Contemporary plastic and reconstructive surgeons in units throughout the United Kingdom and Ireland continue to use leeches to aid salvage of failing flaps.
We carried out a survey of all 62 plastic surgery units in the United Kingdom and the Republic of Ireland to assess the current extent of use, and to investigate current practice. We have shown that the majority of plastic surgery units in the UK and Ireland use leeches post-operatively and that the average number of patients requiring leech therapy was 10 cases per unit per year. Almost all units use antibiotic prophylaxis, but the type of antibiotic and combination used is variable. We outline current practice and suggest a protocol for the use of leeches. Whilst the use of leeches is widespread, the plastic surgery community has progressed little in defining indications for their use or in achieving an accepted protocol for their application in units throughout the UK and Ireland.
The first recorded use of the medicinal leech dates used leeches for blood letting, and through the back to ancient Egypt, with images of the leech development of his humoral concept of disease adorning the walls in a sepulchre of the 18th made leech therapy widespread. The belief was dynasty pharaohs — BC. Do you use antibiotics routinely post-operatively States of America were almost exhausted. Govern- when leeches are applied?
Do you disinfect sites prior to leech application? How frequently are the leeches monitored?
Do you routinely counsel patients? By the end of the 19th century, the leech had 7. Had any patients refuse treatment with leeches? Were there written protocols for the use of in with the concepts and development of modern leeches? Do you keep leeches in the hospital overnight? The average number of patients requiring which vasodilate and contribute to prolongation of leech treatment was 10 cases per unit using bleeding following a bite.
Thirty seven units used The medicinal leech has been used by recon- prophylactic antibiotics routinely during leech structive surgeons in recent years to aid salvage of application, with augmentin, metronidazole, compromised microvascular free-tissue transfers,5,6 benzyl penicillin, ciprofloxacin and flucloxacillin replanted digits,7 ears,8 lips9,10 and nasal tips. Peer-reviewed evidence suggests that the survival The site of application was disinfected by 31 of compromised, venous-congested tissues are units Eleven of the 40 units In the remainder sing the current extent of use of Hirudo Medicinalis, of units, nurses observed at 5 —10 min intervals, and we also assess current practice, and make rec- plastic surgeons observed patients when on the ommendations for future improvements in protocols.
Most units counted leeches on the wound to avoid losing leeches in the dressings. Method Patients were routinely counselled in 21 The names, five units Written protocols the British Association of Plastic Surgeons Website concerning the use of leeches were available in 35 www. Are leeches used post-operatively by the plastic Discussion surgeons in your unit?
How many times per year on average are leeches Our study shows that the majority of plastic surgery used? Whitaker et al. Figure 1 Number of cases requiring Hirudo Therapy per year. Medicinalis to improve drainage from venously Serratia marcescens,23 Aeromonas sobria24 and congested tissue post-operatively. Although pro- Vibrio fluvialis. Six different anti- API20E method was used for identification pur- biotics were used, either individually or in poses. The microbe was almost certainly an Aero- combination. Infection is possibly the most first generation cephalosporins and penicillins27,28 worrisome complication of leech application and and the occasional finding of extended b-lacta- generally presents as cellulitis or a local abscess.
Our recommendation would be to from cellulitis to extensive tissue loss and septi- use a quinolone for example ciprofloxacin with caemia. Since three Aeromonas genos- removal of the leech has long been considered a complication. In Anthony White reported that pecies Aeromonas hydrophila, Aeromonas sobria a 2-year-old girl had died with the loss of blood and Aeromonas caviae have been subdivided into induced by a single leech.
The bleeding, hydrophila are a recognised complication of leech however, in the vast majority of cases can be well application, first described in this journal in It is sensible to keep a daily check on the ing wound infection following Hirudo therapy that haemoglobin during leech therapy, particularly in have been reported in the literature include; young children.
Anaphylaxis and local allergic reactions to salivary secretory products have been described,30 and excessive scarring has been associated with leeching. Upper airway obstruction has been described following leech migration to the hypopharynx and subsequent engorgement with blood, and haemoptysis has been reported following leech migration to the bronchus.
The majority used saline or sterile water, We suggest a protocol based on our review of with three units using alcohol.
Dampen a square of gauze fresh blood. This will form a barrier to help prevent the cing leeches in a smoke filled room impeded leech leech from migrating. The area can be then pricked attachment.
This technique could prove valuable in encouraging the leech to feed can be taxing. It is important to Patient information leaflets were not often avail- be vigilant and check the wound site often to ensure able. All units got informed consent from the that the leech has not migrated or detached patient before leech therapy was instituted, and prematurely which may result in aforementioned it was well received by virtually all, with only a complications. But what if they fail? View on PubMed.
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