Aftercare

When the leech detaches, a small wound is left on the skin, which may continue to bleed for several hours. Bleeding for 12 hours is perfectly normal, but it can also last more than 24 hours. The bleeding usually stops the following day. The therapist covers the wound with sterile gauze or cotton wool and, after a while, checks how the bleeding is progressing. Bleeding is an integral part of the therapy, and it is very important that it stops on its own, without compression. Prolonged bleeding serves to cleanse the wound and in this way we avoid any possibility of the wound becoming infected.

On the first day, the wound is generally not re-dressed; instead, further bandages are simply added over the gauze. Clean towels are also useful and can be wrapped over the bandages. Single-use absorbent materials, such as nappies, sanitary towels and changing mats, may also be wrapped over the gauze and bandages.

While the wound is bleeding, drinking excessive amounts of fluid is not advisable, as this can stimulate lymphatic activity and additional bleeding. Because of the greater blood loss, isotonic drinks are recommended. Once the bleeding has stopped, however, drinking plain water in as large a quantity as possible is encouraged.

The scab that forms on the wound falls off after about a week. To avoid damaging the scab, it is advisable to protect the wound for a few more days. It is enough to cover the wound for a few days with gauze fixed in place with tape, or with plasters. This prevents the wound from being damaged by clothing or the scab from being scratched off. Although extremely rare (statistically 7 in 100,000 therapies), secondary infections do occur following leech therapy. This is also the most common form of complication. Their cause lies precisely in damage to the wound caused by clothing or fingernails. In the first few days after the therapy, swimming in pools is not permitted.

At the site of the bite, then, a small wound remains, on which a scab forms in the same shape. Around the wound a dark blue or purple circle, about the size of a five-cent coin, usually appears. Depending on the skin type, a larger bruise may also develop – as with a knock. When the scab falls off, as with other grazes, depigmentation may remain at the site of the bite. This usually fades over time. Skin that is prone to scarring may develop a keloid, so in people susceptible to this the therapy is not carried out, or is not carried out on exposed parts of the body.
Around the wound, swelling may appear for a day or two. This can be particularly pronounced on parts of the body where there is little tissue – e.g. joints, fingers. The patient will feel tightness and heat in this area, and redness may also appear. As the wound heals, (intense) itching often occurs, as after a mosquito bite. To relieve the itching and to cool the wound, we can use vinegar or lemon compresses, tea tree oil or creams such as Kamagel or Bepanten.

By applying the Systemic treatment method, we avoid tissue swelling, haematomas, prolonged bleeding, oedema and itching. As this is the safest method of leech therapy, we use it in most cases.