ID 106359
Author
Kashiwagi, Keisuke Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Hashimoto, Ichiro Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Abe, Yoshiro Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Kotsu, Kunio Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Yamano, Masahiro Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School
Nakanishi, Hideki Department of Plastic and Reconstructive Surgery, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
leech therapy
congestion
island flap
microcirculation
TcPO2 and TcPCO2 monitoring
Content Type
Journal Article
Description
Background A congested flap is a good indication for leech therapy. However, determining the appropriate number of leeches as well as the appropriate application time in clinical cases is difficult. We analyzed hemodynamics in rabbit island flaps under leech therapy to find a suitable clinical procedure for determining the appropriate number of leeches to be used and the duration of therapy. Methods Island flaps were raised in 35 rabbit ears, and congestion was induced by venous clamping. Treatment involved use of 1 or 3 leeches and was begun 60 minutes after venous occlusion. Flaps were examined for area of surviving tissue, alterations in transcutaneous oxygen and carbon dioxide tension (TcPO2 and TcPCO2), and flow volume. Arteriole and venule diameters and flow velocities were examined microscopically. Results Flap survival area in the 3-leech therapy group was significantly larger than the 1-leech therapy group and the control group. With 3- leech therapy, TcPCO2 decreased significantly, as did arteriole and venule diameters. After clamp release, TcPCO2 and venule diameter continued to decrease in this group, and flow velocity increased significantly. Conclusions Leech therapy may salvage compromised flaps by replacing congested blood with new arterial blood and thus maintaining flap viability. TcPO2 and TcPCO2 monitoring may help evaluate the therapeutic effect and determine the appropriate number of leeches to apply and the duration of therapy.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
60
Issue
3-4
Start Page
213
End Page
220
Sort Key
213
Published Date
2013-08
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences