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Epilogue
Use of Hirudo medicinalis in paediatric reconstructive surgery
  1. Enrico Valerio1,
  2. Giusy Castiglione2,
  3. Marco Olivo2,
  4. Paola Ferrarese1,
  5. Stefano Spanio Di Spilimbergo2
  1. 1 Pediatric Intensive Care Unit, San Bortolo Hospital, Vicenza, Italy
  2. 2 Maxillofacial Surgery Unit, San Bortolo Hospital, Vicenza, Italy
  1. Correspondence to Dr Enrico Valerio, Pediatric Intensive Care Unit, Ospedale San Bortolo, Viale Ferdinando Rodolfi, Vicenza 37, 36100, Italy; enrico.valerio.md{at}gmail.com

http://dx.doi.org/10.1136/archdischild-2017-313306

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    Mandible reconstruction with a scapular osteomyocutaneous flap was performed in a 12-year-old boy after removal of a desmoid fibroma. Onset of flap venous congestion led to early surgical re-exploration, which did not reveal any vascular or blood flow anomaly of the flap pedicle’s vein at the anastomosis site.

    Medicinal leeches (ML) application was then started (figure 1); an intensive schedule was followed for the first 4 days, subsequently tapered until discontinuation in accordance with congestion reduction. On hospital discharge, overall excellent flap reperfusion was achieved (figure 2).

    Figure 1

    Leeches application.

    Figure 2

    Final result on hospital discharge.

    Questions

    1. Which statement reflects the history of ML application?

    1. They only have been used after approval as a medical device by the American Food and Drug Administration (FDA) in 2004.

    2. ML use dates back to 3500 years ago, and remained frequently used in current practice.

    3. First reports of ML use as a medical …

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    Footnotes

    • Contributors EV wrote the first draft of the manuscript; GC, MO, PF and SSDS contributed to the critical revision of the manuscript; SSDS also produced the iconographic documentation.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.