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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).
1. Which statement reflects the history of ML application?
They only have been used after approval as a medical device by the American Food and Drug Administration (FDA) in 2004.
ML use dates back to 3500 years ago, and remained frequently used in current practice.
First reports of ML use as a medical …
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.
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