Wound healing immediately starts after an injury and
proceeds with a complicated but well-organized interaction
among various types of tissues and cells [1]. Skin-wound
healing consists of the inflammatory, proliferative, and
maturation phases [1]. In the inflammatory phase, the
recruitment of leukocytes such as neutrophils and macrophages
into the wound site is characteristic. In the proliferative
phase, the migration and proliferation of
keratinocytes, fibroblasts, and endothelial cells result in reepithelialization
and tissue granulation. In the maturation
phase, excess collagen in the wound site is degraded by
several proteolytic enzymes, leading to the completion of
tissue repair [2]. It is considered that perfusion is an
important factor in accelerating the healing rate of skin
wounds. The saliva of medicinal leeches demonstrated such
an ability of perfusion.
Leech therapy (LT) has made resurgence in Russia for the
treatment of hypertension, migraines, phlebitis, varicose
veins, arthritis, hemorrhoids, and ovarian cysts. LT was a
mainstay in conventional treatment of pain and inflammatory
diseases since the ancient ages until the 20th century
[13,14].
In the United States, plastic surgeons use leeches to drain
blood from wounds after limb or tissue reattachment. The
application of LT in modern medicine is greatly diverse [15].
The World Health Organization has recommended traditional
medicines to be used more effectively in the health-care
systems [13]. LT is a procedure that has been recommended
in traditional Iranianmedicine and traditionally used by native inhabitants and physicians (Hakims) for centuries in the
treatment of hemorrhage, fever, etc. [16].