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GENERAL PATIENT CARE The area around leech bite wounds should be routinely observed for local infection, and swabs taken if indicated. If bleeding is present, patient's hemoglobin levels should be checked daily. It is quite possible for significant falls in hemoglobin levels to occur. POST-BITE CARE...

MODE OF ACTION The leech's main therapeutic benefits are not derived from the average 5 mls of blood removed during biting (although this may provide dramatic relief at first), but from the anticoagulant and vasodilator contained in the leech saliva. These properties permit the wound to ooze up to 5...

INDICATORS FOR THERAPEUTIC USE OF LEECHES Leeches are generally useful on replanted digits, ring avulsion injuries and in small free flaps where there is good arterial inflow but no venous outflow. Before the decision to use leeches is made, however, it is recommended that consideration be given to ...

APPLYING LEECHES The animals should be applied in adequate numbers to the general area of maximal congestion. One (1) or two (2) leeches may be sufficient to treat the skin of a partially degloved or replanted finger, whereas a large flap may require 6 or more depending on initial clinical response....