Salvage of three cases of class 2V ring finger avulsion injuries with medicinal leeches

Abstract

Three cases of the successful salvage of ring finger degloving injuries using medicinal leeches are described. In each case, good arterial inflow was present in the avulsed soft tissue, but venous insufficiency would have prevented viability. If venous microvascular repair failed, venous return could be temporarily provided by leeches, applied to the finger every 4 to 6 h. The leech drew blood for an average of 20 mins, but the bite site on the finger tip continued to ooze blood slowly as a result of an anticoagulant, hirudin, injected by the leech. This external venous run-off provided the equivalent of internal venous return until vascular ingrowth permitted true internal venous return, five to eight days after injury. Early movement and Coban taping assisted the achievement of a good early range of motion in the three salvaged digits.