“Therapeutic Leech Application in Acute Road Traffic Trauma: An Adjunct in Emergency Management” - A Case Report

Abstract

Leech therapy, an ancient therapeutic modality described in traditional systems of medicine and now recognized in modern reconstructive practices, possesses unique biological properties that make it useful in the management of venous congestion and compromised tissue perfusion. Medicinal leeches, particularly Hirudo medicinalis, secrete a variety of bioactive substances in their saliva, including hirudin, calin, destabilase, and hyaluronidase. These substances exhibit anticoagulant, anti-inflammatory, vasodilatory, and thrombolytic effects, thereby enhancing local blood circulation and promoting tissue healing. Because of these properties, leech therapy has gained importance as an adjunctive treatment in traumatic injuries, reconstructive surgeries, and conditions associated with venous stasis. This case report describes the successful application of leech therapy in a 20-year-old male patient who sustained a lacerated injury near the right eyebrow following a road traffic accident. After initial wound management and primary suturing, the patient developed significant periorbital venous congestion characterized by progressive edema, bluish discoloration (cyanosis), and compromised tissue perfusion around the wound site. Considering the risk of tissue ischemia and necrosis due to impaired venous outflow, controlled application of medicinal leeches was undertaken as a supportive therapeutic intervention.