Efficiency of medical leech on experimentally induced incisional wound healing in rats

Alican Bilden; Özlem Kara; Merve Kahraman; Nebahat Çağlayan; Muttalip Çiçek

doi:10.1515/jcim-2024-0351

Article

Efficiency of medical leech on experimentally induced incisional wound healing in rats

Alican Bilden , Özlem Kara , Merve Kahraman , Nebahat Çağlayan and Muttalip Çiçek

Published/Copyright: February 3, 2025

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal Journal of Complementary and Integrative Medicine Volume 22 Issue 2

Abstract

Objectives

This study was conducted in response to the increasing interest in understanding the effects of both modern and traditional complementary medicine on incisional wound healing. Herein, it was aimed to investigate the wound healing effects of medicinal leech therapy and leech saliva in an experimentally created incisional skin wound model.

Methods

Fifteen rats underwent full-thickness incisions on their dorsal regions and were randomly assigned to five equal groups, as the Leech Saliva (LS) group, where wounds were treated topically with leech saliva once daily; Leech Therapy-1 (LT-1) group, where leech therapy was administered once at the beginning of the experiment; Leech Therapy-2 (LT-2) group, where leech therapy was applied twice, on days 0 and 3; Positive Control (PC) group, where wounds were treated daily with Phyto cream containing Triticum vulgare; and Negative Control (NC) group, where no treatment was given.

Results

Wound healing was assessed daily, and the experiment continued until complete healing was observed. At the conclusion, the wound size, appearance, and histological features were analyzed to compare healing progress across the groups.

Conclusions

Medicinal leech therapy was observed to have a positive wound healing effect in the rat model.

Keywords: medicinal leech therapy; incisional wound; in vivo

Corresponding author: Assist. Prof. Alican Bilden, Faculty of Medicine, Department of Medical Parasitology, Kırşehir Ahi Evran University, Kırşehir, Türkiye, E-mail: alican.bilden@ahievran.edu.tr

Research ethics: This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and was approved by the Kırşehir Ahi Evran University Animal Experiments Ethics Committee (approval number 2024-08/8).
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: Alican Bilden: Concept, Design, Analysis or Interpretation, Literature Search, Writing. Özlem Kara: Data Collection or Processing, Analysis or Interpretation. Merve Kahraman: Data Collection or Processing, Writing. Nebahat Çağlayan: Data Collection or Processing. Muttalip Çiçek: Concept, Design. All authors approved the submitted manuscript.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interests: Authors state no conflict of interest.
Research funding: The authors received no external funds for the research and publication of this article.
Data availability: The data supporting the findings of this study are available from the corresponding author upon reasonable request.

References

1. Pereira, RF, Barrias, CC, Granja, PL, Bartolo, PJ. Advanced biofabrication strategies for skin regeneration and repair. Nanomedicine 2013;8:603–21. https://doi.org/10.2217/nnm.13.50.Search in Google Scholar PubMed

2. Clark, RAF, editor. The molecular and cellular biology of wound repair. New York: Springer; 2013.Search in Google Scholar

3. Sussman, C, Bates-Jensen, BM. Wound care: a collaborative practice manual. Philadelphia: Lippincott Williams & Wilkins; 2011.Search in Google Scholar

4. Guo, S, DiPietro, LA. Factors affecting wound healing. J Dent Res 2010;89:219–29. https://doi.org/10.1177/0022034509359125.Search in Google Scholar PubMed PubMed Central

5. Sun, X, Jiang, K, Chen, J, Wu, L, Lu, H, Wang, A, et al.. A systematic review of maggot debridement therapy for chronically infected wounds and ulcers. Int J Infect Dis 2014;25:32–7. https://doi.org/10.1016/j.ijid.2014.03.1397.Search in Google Scholar PubMed

6. Deshmukh, PT, Gupta, VB. Embelin accelerates cutaneous wound healing in diabetic rats. J Asian Nat Prod Res 2013;15:158–65. https://doi.org/10.1080/10286020.2012.758634.Search in Google Scholar PubMed

7. Duzgun, G, Celik, A, Durmaz Akyol, A. Medical leeches and hirudotherapy: where is nurse’s role? J Educ Res Nurs 2021;18:276–81. https://doi.org/10.5152/jern.2021.13540.Search in Google Scholar

8. Nair, HKR, Ahmad, NW, Lee, HL, Ahmad, N, Othamn, S, Mokhtar, NSHM, et al.. Hirudotherapy in wound healing. Int J Low Extrem Wounds 2020;1–7. https://doi.org/10.1177/1534734620948299.Search in Google Scholar PubMed

9. Whitaker, IS, Rao, J, Izadi, D, Butler, PE. Historical article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history. Br J Oral Maxillofac Surg 2004;42:133–7. https://doi.org/10.1016/s0266-4356(03)00242-0.Search in Google Scholar PubMed

10. Lemke, S, Vilcinskas, A. European medicinal leeches-New roles in modern medicine. Biomedicines 2020;8:1–12. https://doi.org/10.3390/biomedicines8050099.Search in Google Scholar PubMed PubMed Central

11. Müller, C, Haase, M, Lemke, S, Hildebrandt, JP. Hirudins and hirudin-like factors in Hirudinidae: implications for function and phylogenetic relationships. Parasitol Res 2017;116:313–25. https://doi.org/10.1007/s00436-016-5294-9.Search in Google Scholar PubMed

12. Mumcuoglu, KY. Recommendations for the use of leeches in reconstructive plastic surgery. Evid base Compl Alternative Med 2014:1–7. https://doi.org/10.1155/2014/205929.Search in Google Scholar PubMed PubMed Central

13. Das, BK. An overview on hirudotherapy/leech therapy. Indian Res J Pharmaceut Sci 2014;1:33–45.Search in Google Scholar

14. Koeppen, D, Aurich, M, Rampp, T. Medicinal leech therapy in pain syndromes: a narrative review. Wien Med Wochenschr 2014;164:95–102. https://doi.org/10.1007/s10354-013-0236-y.Search in Google Scholar PubMed

15. Abdullah, S, Dar, L, Rashid, A, Tewari, A. Hirudotherapy/leech therapy: applications and indications in surgery. Arch Clin Exp Surg 2012;1:172. https://doi.org/10.5455/aces.20120402072447.Search in Google Scholar

16. Abdualkader, MA, Merzouk, A, Ghawi, AM, Alaama, AM. Some biological activities of malaysian leech saliva extract. IIUM Eng J 2011;12:1–9. https://doi.org/10.31436/iiumej.v12i4.156.Search in Google Scholar

17. Singh, AP. Medicinal leech therapy (Hirudotherapy): a brief overview. Compl Ther Clin Pract 2010;16:213–15. https://doi.org/10.1016/j.ctcp.2009.11.005.Search in Google Scholar PubMed

18. Wiwanitkit, V. Leech therapy. Ancient Sci Life 2012;31:141. https://doi.org/10.4103/0257-7941.103199.Search in Google Scholar PubMed PubMed Central

19. Zaidi, SMA, Jameel, SS, Zaman, F, Jilani, S, Sultana, A, Khan, SA. A systematic overview of the medicinal importance of sanguivorous leeches. Alternative Med Rev 2011;16:59–65.Search in Google Scholar

20. Herlin, C, Bertheuil, N, Bekara, F, Boissiere, F, Sinna, R, Chaput, B. Leech therapy in flap salvage: systematic review and practical recommendations. Ann Chir Plast Esthet 2017;62:1–13. https://doi.org/10.1016/j.anplas.2016.06.004.Search in Google Scholar PubMed

21. Asutkar, S, Varshney, S. An interdisciplinary critical review of leech therapy; evolution, indications, salivary gland secretions and mode of action – the scientific way. J Pharm 2019;9:10–18.Search in Google Scholar

22. Tasiemski, A. Antimicrobial peptides in annelids. Invertebr Surviv J 2008;5:75–82.Search in Google Scholar

23. Moosavian, HR, Mirghazanfari, SM, Moghaddam, KG. Effect of ischemia preconditioning and leech therapy on cutaneous pedicle flaps subjected to prolonged ischemia in a mouse model. Aesthetic Plast Surg 2014;38:1024–9. https://doi.org/10.1007/s00266-014-0399-y.Search in Google Scholar PubMed

24. Zakian, A, Ahmadi, HA, Keleshteri, MH, Madani, A, Tehrani-Sharif, M, Rezaie, A, et al.. Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model. Res Vet Sci 2022;153:153–68. https://doi.org/10.1016/j.rvsc.2022.10.015.Search in Google Scholar PubMed

25. Verriere, B, Sabatier, B, Carbonnelle, E, Mainardi, JL, Prognon, P, Whitaker, I, et al.. Medicinal leech therapy and Aeromonas spp. infection. Eur J Clin Microbiol Infect Dis 2016;35:1001–6. https://doi.org/10.1007/s10096-016-2629-5.Search in Google Scholar PubMed

26. Darestani, KD, Mirghazanfari, SM, Moghaddam, KG, Hejazi, S. Leech therapy for linear incisional skin-wound healing in rats. J Acupunct Meridian Stud 2014;7:194–201. https://doi.org/10.1016/j.jams.2014.01.001.Search in Google Scholar PubMed

27. Institute of Laboratory Animal Resources (US). Committee on care, and use of laboratory animals. Guide for the care and use of laboratory animals. No. 86. Bethesda, MD: US Department of Health and Human Services, Public Health Service, National Institutes of Health; 1986.Search in Google Scholar

28. Gethin, G, Cowman, S. Wound measurement comparing the use of acetate tracings and VisitrakTM digital planimetry. J Clin Nurs 2006;15:422–7. https://doi.org/10.1111/j.1365-2702.2006.01364.x.Search in Google Scholar PubMed

29. de Almeida, SM, da Cruz, AD, Ferreira, RI, Vizioli, MR, Bóscolo, FN. Effect of low-dose electron radiation on rat skin wound healing. Braz Dent J 2007;18:208–14. https://doi.org/10.1590/s0103-64402007000300006.Search in Google Scholar PubMed

30. Emami, RS, Esmaeili, DN, Forouzannia, S, Amanpour, S, Rabani, S, Alizadeh, M, et al.. Effect of bentonite on skin wound healing: experimental study in the rat model. Tehran, Iran: Acta Medica Iranica; 2006:235–40 pp.Search in Google Scholar

31. Ünal, K, Tırık, N, Erol, ME, İbrahimkhanlı, L, Elçi, MP, Ayhan, H. The investigation of effects of medicinal leech saliva extract on the breast fibroblast cell line in vitro: an experimental study. J Tradit Med Compl Ther 2023;6:142–51. https://doi.org/10.5336/jtracom.2022-92875.Search in Google Scholar

32. Mousavian, A, Sabzevari, S, Parsazad, S, Moosavian, H. Leech therapy protects free flaps against venous congestion, thrombus formation, and ischemia/reperfusion injury: benefits, complications, and contradictions. Arch Bone Jt Surg 2022;10:252–60.Search in Google Scholar

33. Battin, AO, Hobeika, N, Zdilla, MJ. Systematic review of medicinal leech therapy in urology. Afr J Urol 2023;29:21. https://doi.org/10.1186/s12301-023-00351-9.Search in Google Scholar

34. Choi, JH, Kim, EH, Choi, N, Beak, CH, Chung, MK. Leech therapy for the salvage of complicated reconstructive flaps after head and neck cancer surgery. J Clin Otolaryngol Head Neck Surg 2020;31:51–6. https://doi.org/10.35420/jcohns.2020.31.1.51.Search in Google Scholar

35. Boissiere, F, Gandolfi, S, Riot, S, Kerfant, N, Jenzeri, A, Hendriks, S, et al.. Flap venous congestion and salvage techniques: a systematic literature review. Plast Reconstr Surg Glob Open 2021;9:3327. https://doi.org/10.1097/gox.0000000000003327.Search in Google Scholar PubMed PubMed Central

36. Sorg, H, Sorg, CGG. Skin wound healing: of players, patterns, and processes. Eur Surg Res 2023;64:141–57. https://doi.org/10.1159/000528271.Search in Google Scholar PubMed

37. Wilkinson, HN, Hardman, MJ. Wound healing: cellular mechanisms and pathological outcomes. Open Biol 2020;10:200223. https://doi.org/10.1098/rsob.200223.Search in Google Scholar PubMed PubMed Central

38. Peña, OA, Martin, P. Cellular and molecular mechanisms of skin wound healing. Nat Rev Mol Cell Biol 2024:1–18. https://doi.org/10.1038/s41580-024-00715-1.Search in Google Scholar PubMed

Received: 2024-10-02

Accepted: 2024-12-31

Published Online: 2025-02-03

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/jcim-2024-0351

Keywords for this article

medicinal leech therapy; incisional wound; in vivo