Leeches have been used in medicine long time before BC. In recent years medical leech therapy has gained increasing
interest in reconstructive surgery and pain management and other medical fields. The possible indications and success
rates of this treatment are discussed. There is a special interest in salvage of flaps and grafts by the use of medical
leeches. Retrospective analysis indicates a success rate of >80%. Randomized controlled trials have been performed in
osteoarthritis. Case reports and smaller series are available for the treatment of chronic wounds, post-phlebitic syndrome
and inflammatory skin diseases. The most common adverse effects are prolonged bleeding and infection by saprophytic
intestinal bacteria of leeches. Medical leech therapy is a useful adjunct to other measures wound management.