Equipment Needed to Apply Leeches
1. Disposable bottle of sterile water.
2. Packet of gauze swabs.
3. Scissors and non-toothed forceps.
4. Small "Op-Site" dressing (optional).
5. Container of sterile water with HIRUDOSALT solution, for placing leeches after they have been fed. This container must be labelled with patient's name.
The animals should be applied in adequate numbers to the general area of maximal congestion. The head (or biting end) of the animal can be recognised by its searching movements, while the tail end is used mostly as a sucker for fixation. It is best to use the hungriest (normally the smallest) leeches first. Preferably do not use forceps forcibly on the leech.
1. Clean patient's skin thoroughly with soap and water to remove all substances with strong odour or taste such as traces of operative prep fluids or saline. Rinse cleaned areas with plain water.
2. Dampen a square of gauze with water and cut a 1cm hole in the middle. Place the gauze on the patient with the hole in close contact with the area to be treated. This will form a barrier to prevent the leech from wandering.
3. Steer the head of the leech to the hole in the gauze. Attachment generally occurs quickly. However, if the leech is reluctant to bite, make a small needle prick on the skin to produce a tiny droplet of blood (which should result in enthusiastic attachment).
4. Once the leech is attached, it will likely remain safely in place until fully distended. The gauze square can be removed and used elsewhere without disturbing the animal. However, it is important that the site be checked continuously to ensure the leech hasn't moved.
5. Leeches usually stay attached at a truly congested site for 30 to 60 minutes. If the blood supply is poor (in which case the diagnosis of venous congestion is probably wrong), they may detach prematurely and attempt to wander to another site, for example, normal skin. Leech movement can be prevented by simple physical persuasion, but the best way to avoid wandering is to pre-cut holes in a sheet of "Op-Site" dressing and apply this to the treatment area.
6. Leeches may simply drop off the skin when satisfied and will not attempt to bite again. They should then be placed in a jar and labelled with the patient's name. This will avoid confusion between used and unused animals and
prevent use on another patient.
Dealing With Leeches After Use
1. Return unused leeches to the pharmacy in sterile water.
2. Leeches which have been used on a patient should be disposed of by initially narcotizing them with 8% alcohol and then placing them in 70% alcohol in a galley-pot for 5 minutes and then discarding them via a sluice or incinerator.
Our new product, LEECH NOSDA™, offers a complete kit to humanely and easily dispose of leeches. For more details on LEECH NOSDA™ please see our Maintenance & Products section.
NEVER re-use a leech on a second patient and NEVER return a used leech to a pharmacy.
Post-bite Care of Wound
The major therapeutic effect of leech application occurs during the post-bite period, and depends greatly on the care given to the bite wounds. Each bite must be encouraged to bleed by the gentle removal of any locally forming clot at regular intervals. Clinical response of the tissue being treated should be closely observed during this period.
General Patient Care
The area around leech bite wounds should be routinely observed for local infection, and swabs taken if indicated. If bleeding is severely prolonged, haemoglobin levels should be checked daily. It is quite possible for significant falls to occur.