Safety & Adverse Effects of leech therapy
Leech therapy rarely ever leads to serious complications. The local pain of treatment and short-term itching are regular side effects. . The following analysis was compiled using the data from published efficacy studies and case reports, as well as from personal observations.
Local Pain During Therapy
Perceptions of the local pain of leeching vary. Most clients describe a local dragging pain that occurs immediately after the leech bites and persists for around one to five minutes. As more and more saliva is introduced into the tissues, the anesthetic effect of leech saliva begins to take effect. The intensity of the pain of the leech bite and the first phase of feeding is generally described as mild or negligible (depending on the individual's pain threshold), A slight (or sometimes somewhat stronger) rhythmic pulling sensation is usually noticed for the first one to three minutes after the start of feeding.
Whether stimuli of exactly the same intensity are perceived as painful or are not perceived at all is certainly dependent on the individual's personality, but also depends on that person's concentration on the leech or attitude toward leech therapy. Many people never even notice the leech bite, for example when they are bitten under water while their attention is focused on something else. Frequently, the more anxiously the patient focuses on the leech preparing to bite, the higher the pain perception.
Local itching
Transient itching at the site of the leech bite in the first few days after treatment is very common and should not be mistaken for an allergic reaction. In the study of the efficacy of leech therapy in patients with osteoarthritis of the knee, roughly 70% of patients treated with leeches developed local itching that lasted a mean of two days. The patient should never scratch the leech bite, especially after initial wound closure, because this frequently delays wound healing. We recommend local cooling remedies ( cold moist wraps). For more severe itching, commercial antipruritic products (e.g., Penadryl ointment) or oral antihistamines may be used. Isolated reports describe brief recurrences of moderate itching in certain situations (e.g., high temperatures) .
Hypotension and Vasovagal Attacks
Patients with a history of developing vasovagal attacks or syncope (fainting) before other invasive healing methods may also develop such a reaction at the start of or during leech therapy. To guard against vasovagal attack, the patient should drink plenty of fluids before and during session, Leeching has a known antihypertensive effect when treating patients on antihypertensive medications. Patients should drink plenty of fluids.
Blood Loss
Leech therapy is always associated with a certain degree of blood loss, which is clinically irrelevant in most cases. the mean hemoglobin loss was 0.7 mg/dL... In another case, afterbleeding from the leech bite lasted over 36 hours and had to be stopped with a cutaneous suture.. Anticoagulants are important concurrent medications to watch for,especially low-dose aspirin if prescribed in combination with other platelet aggregation inhibitors (clopidogrel, Iscover, Plavix) or high-dose fish oil (Omacor).
Impaired Wound Healing, infection, and Allergies
After the leech drops off, the edges of the three-pronged wound generally swell for 12-48 hours accompanied by a feeling of local tension, heat, and reddening. Small blood spots (ecchymoses) develop below the skin around the leech bite. Larger collections of blood rarely develop. As with superficial bruising, the blood spots are initially reddish violet, then turn yellowish, and finally disappear within around two weeks. Localized inflammation, sometimes with papulous elevation of the bite sites, is a relatively common problem that is often accompanied by itching . These inflammations usually subside quickly when iced and left undisturbed. Improper handling, especially early stoppage of afterbleeding from the wound. The client should protect the wound from mechanical irritation.Short-term reactive swelling and/or tenderness of proximal lymph nodes has occasionally been reported, but most commonly in clients with delayed wound healing. These symptoms have most frequently developed in the groin region after application of leeches for treatment of the knee joint, hip joint, or varicose veins. Rapid and uneventful disappearance of lymph node swelling is described in all of the cases.
Sepsis
Sepsis due to systemic infection with Aeromonas hydrophila has been repeatedly observed after leech application in reconstructive surgery indications, due to compermized immune system of the person due to surgery, but not in any of the other relevant fields of use. This supports the conclusion that the risk of Aeromonas hydrophila sepsis is increased only in patients with severe underlying diseases or immunosuppression, which is often the case in surgical candidates for leech therapy.
Transmission of Diseases
Today, medicinal leeches are generally only used once. Therefore, there is no risk of the indirect transfer of infectious diseases from one patient to another. Primary infection with Aeromonas hydrophila is relevant only when leeches are applied to surgical transplants. The transmission of other bacterial or viral pathogens to humans within the context of leech therapy has not been observed .
Scarring
When left undisturbed, leech scars usually quickly shrink to hardly visible or invisible tiny three-pronged marks that disappear completely within one to three weeks. However, if wound healing is impaired due to scratching or secondary wound infection, the scars may remain visible for significantly longer periods of time.For esthetic reasons, restraint is advised when using leeches in the facial region or in other clearly visible and cosmetically relevant parts of the body.