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Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Sep;116(3):e167-72. doi: 10.1016/j.oooo.2011.12.020. Epub 2012 Jul 21.

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

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  • 1Department of Oral & Maxillofacial Surgery, Darnall Army Medical Center, Fort Hood, Texas 76548, USA.



To this day, a standardized protocol for medicinal leech therapy does not exist. The purpose of this article was to review literature in the hope of proposing a unified, coherent, feasible, and safe protocol for using medicinal leeches when warranted.


A literature search was conducted in the following databases: PubMed, MDConsult, The Cochrane Library, OMIM, and Google. This was supplemented by a search for selected authors. Keywords used were medicinal leech therapy, leech therapy, leeching, replantation, thromboembolism, venous congestion, Hirudo medicinalis, Hirudotherapy, leech protocol, and Hirudo protocol.


Based on titles and abstracts, 26 articles and 1 Web site were identified.


Leech therapy can be an excellent alternative for the treatment of venous congestion in free flaps, pedicled flaps, and replanted tissues. Psychological precounseling, antibiotic therapy, number of leeches to be used, length of therapy, and laboratory checks should be taken into consideration before initiating therapy.

Published by Mosby, Inc.

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