4. Discussion
Leeches have been used for medicinal purposes since
ancient times with varying success [22]. They secrete
various anticoagulant agents (e.g., hirudin, factor Xa inhibitor)
into a wound, which prevent scab formation, subsequently
accelerating the process of healing [40].
In a study on venous-compromised rat epigastric flaps it
has been shown that the extent of flap necrosis resulting
from venous impairment can be partly diminished by leech
treatment until definitive surgical venous revascularization
[20]. In another study on the efficiency of LT in reconstructive
maxillofacial surgery, the results confirmed the
excellent and predictable healing after LT for local and
microsurgical anastomosed flaps in the case of venous
congestion [19]. Other relevant studies also showed the
efficacy of LT in the treatment of venous congestion in flaps
[41e44].
In this study, the comparative effect of LT and PHT (1%)
on incisional skin-wound healing in rats has been studied.
As mentioned in the “Health Condition of Rats” section,
the LT group had the highest level of health condition in all
time intervals. At the beginning of the experiment, the rats
in all three experimental groups were all normal and
active. However, there was an obvious decrease of health
parameters in the PHT and control groups when evaluated
at Days 3 and 7. Therefore, it can be concluded that LT had
a greater effect in improving the health condition of rats in
comparison with the PHT and control groups. Thus, it can
be concluded that the LT group was the healthiest and rats
in the group were normal and active. A literature review
showed no similar study had been carried out previously to
assess the health condition of rats on the basis of behavioral
parameters.
On Day 7, in the LT group (Fig. 5), the entire wound area
was covered with new hair and the wound vestiges on skin
could barely be recognized. This shows the great effect of
LT on hair growth and wound closure. Faster growth of new
hair in the LT group is probably due to better nutrition of
hair follicles by enhancing blood circulation in the wound
area that is described as one of effects of LT on tissues.
The reduction of wound area has been shown with
negative r values in the two-tailed correlation test. A
literature review showed no similar study had been carried
out previously to determine wound-area changes by LT and
1% PHT.
As discussed in the “Comparison of Wound Healing in
Different Groups” section, the percentage of wound healing is more than 80% in the LT group, somewhat more
than 60% in the PHT group, and 40% in the control group
when evaluated on Days 1 and 3. In Fig. 7, the rapid change
and steep slope of the graph indicate that most of the
healing process (like the inflammation and proliferation
phases) occurred on Days 1 and 3. However, regeneration of
skin tissues was noticed only on Day 7.