PRODUCT

Preparation and practice

Prepare a container to put leeches in.
Prepare a blood pressure gauge, lancets, disposable gloves, disposable bandage, cotton balls, plaster, gauze, etc.

By using a lancet, form blood at the area which will be bitten by medical leeches.
Use disposable gloves or tweezers to gently grab the 2/3 section of the leech and adhere the leech’s mouth on the diseased part.
Allow the leech to bite the area by repeating the process of removing and putting the leach back until it bites.

Once the leech starts sucking blood, wait for a while until it sucks a sufficient amount of blood. If placing a leech on a small area, prepare the leech one at a time.
If the leech sticks to a wrong area other than the diseased part before sucking blood, gently remove the sucker attached to your skin.
Also, if the leech has sucked some blood from the patient but fails to suck blood continuously, it is prohibited to reuse the same leech for another patient.
Make sure you don’t place any unused leeches back in the container.

In general, if a leech has sucked enough blood, it will naturally separate itself from the area, but it is possible to artificially remove the leech after 80 minutes.
This is because it has taken sufficient time for the smooth blood circulation and the suitable amount of a leech’s saliva, which is a pharmacological ingredient, has entered inside the body.

The important steps of leech therapy include not only attachment but also removal.
When you bring a cotton ball soaked with alcohol to the top of the leech’s mouth that sucks up blood (do not come into contact with the mouth), the leech will be removed from the area by turning its mouth.
If the leech spits out blood after being removed from the area, do not panic and simply grab the leech with tweezers to put it in the container. Do not stab the leech with the sharp part of tweezers or remove the leech forcefully or roughly.

After use, place the leech in a container filled with alcohol and handle in an area that is out of the patient’s sight.

As bleeding is likely to continue for up to 24~36 hours after removing the leech, prepare a thick layer of cotton balls on the area and attach the cotton pads over it in a proper size. Finish with a plaster.

A leech sucks up about 2~4mg of blood, and 15~30mg of bleeding would occur after removing it.

Actions to take after treatment

1. Wound with bleeding
   • A thick layer of the gauze or bandage must be prepared. Otherwise, it may fall due to a large amount of blood.
   • If the patient bleeds a lot, change the bandage.
   • If bleeding continues for a long time over 12 hours, use a compression bandage.
   • It is recommended to avoid drinking, smoking, hot bath, sauna, and physical labor on the day of treatment.
2. Leech handling after treatment
   • Do not reuse the same leech.
3. Additional treatment
   • It is recommended to change the bandage after treatment.
   • Replace with a new bandage on the next day.
   • If any side effects are observed, immediately diagnose and treat. A second visit is required within 3~7 days.

Caution

1. Basic rules
   • Do not reuse the leech that has come in contact with a patient’s blood.
   • Because a leech is a living organism, it may move to another area while bloodsucking. It is required to prepare a person in charge of watching over the action for leech therapy after surgery.
   • In the uncommon cases of attaching a leech inside the patient’s mouth or to the tongue after surgery, make sure to keep an eye on it and stuff the mouth with a gauze to prevent any accidents such as the leech entering the throat.
   • It is necessary to consider that a relatively larger amount of bleeding occurs in young patients compared to adult patients.
2. Explanation for the patient about medical leech therapy
   • A detailed explanation of the leech therapy process must be provided to the patient.
   • It is required to explain any actions to be taken by the patient during the treatment process.
   • The doctor must give explanations about the side effects that might occur from the leech therapy.
3. The patient’s consent on leech therapy
   • If possible, it is recommended to obtain the patient’s consent on a written document.
4. Information to be announced to the patient
   • When treating hands or toes with poor blood circulation, prepare a favorable condition by rubbing or using a warm steamed towel.
   • It is recommended to avoid using any products with scents including body wash, soap, perfume, cosmetics, and others before treatment.
   • A patient should wear comfortable clothes that do not tighten the body.
   • If the area treated with a leech is itchy, it is due to histamine from the leech’s saliva that dilates blood vessels.
   • It is important to carefully note if the patients display the tendency of abnormal bleeding.
   • Because leech therapy always involves bleeding, it is safe to perform a blood test and measure blood pressure before treatment. Also, it is important to take into account that a relatively large amount of blood is consumed.
   • Leech therapy for cases related to blood loss including anemia and bone marrow diseases must be consulted with the medical team.
   • If the patient experiences blood coagulation, consult with the medical team first.
   • When taking anticoagulants such as heparin, consult with the medical team first.
   • If the patient experiences erosive gastritis or gastrointestinal bleeding, consult with the medical team first.
   • If the patient suffers from an infectious disease, consult with the medical team first.
   • If the patient has a severe organic disease or takes immunosuppressants, consult with the medical team first.
   • If the patient is severely allergic to the antigen-antibody reaction against the protein secreted from the leech’s salivary gland, consult with the medical team first.
   • If the wound recovery is slow locally or on the entire body, consult with the medical team first.
   • Because keloids may form on the area with a leech bite, consult with the medical team first if the patient generally experiences keloids.
   • Leech therapy for pregnant women must be consulted with the medical team.

The medical team must check the patient’s condition regarding each case, and the patient must be informed of all of the potential side effects in advance.
The notification of the information to the patient in advance may lessen any worries and inconvenience of the patient.