Comparing a Mechanical Device with Medicinal Leeches for Treating Venous Congestion

Abstract

OBJECTIVE: To compare mechanical device therapy to medicinal leech therapy for treating venous congestion.

STUDY DESIGN: Fasciocutaneous flaps of 9 × 7-cm (porcine model, n = 11) were elevated and the associated veins clamped for 15 hours. Device-treated flaps (n = 6) were treated with up to 3 devices/flap. Leech-treated flaps (n = 5) were treated with 75 leeches/flap (5 leeches/hour). Treatment evaluation parameters included: blood volume removed, skin color, surface perfusion, tissue oxygen tension, and endpoint histology.

RESULTS: No significant differences were seen in blood volume removed, surface perfusion, and oxygen tension. However, significant differences were seen in skin color change over time. Histological assessment showed mild congestion in 5/5 leech-treated flaps and 2/6 device-treated flaps.

CONCLUSION: Device therapy was comparable to leech therapy for decongesting a 9 × 7-cm flap over a 15-hour period. However, digital images and significant differences in skin color change over time demonstrate that device therapy promotes more global decongestion versus leech therapy.

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