The technique of posing leeches
In the presence of serious diseases of leeches can put only an experienced doctor-girudoterapevt. The procedure for staging for mild diseases is performed by a trained nurse. Independent formulation is allowed only in the simplest cases and only after the patient has learned the basic rules and techniques for carrying out this procedure.
In hirudotherapy, there are two methods of using medical leeches: aspirating( with bleeding) and without it. The first method, during which the leech sucks up as much blood as the patient needs and disappears by itself, is applied throughout the existence of hirudotherapy. The second method was developed in the XX century. Professor A. S. Abuladze. Its main principle is that the leech is removed from the patient's skin at the beginning of sucking, as a result of which the patient does not have a lot of blood loss.
There are basic rules of the patient's behavior on the day of taking the hirudotherapy session. On this day, you should not take a bath, but also use hygiene products( soap, gel, perfume, creams and other preparations with different smells, including makeup).The intake of alcohol and nicotine is completely excluded. Leeches are very sensitive to various smells, so if they are available even in a weak concentration they will not stick to the skin of the patient.
On the day of the session, heavy physical work should also be avoided.
For the procedure you need pure medical alcohol, hot water( temperature up to 45-55 ° C), oilcloth, and also if necessary - a sterile tray with medical sterile tweezers and sterile cotton swabs. You will also need a towel, gauze or bandages for the bandage, which is superimposed after the end of the session.
Before proceeding to the procedure of leeches , it is necessary to make sure of their suitability. First, you need to make sure that the leeches are healthy. There are several special tests for this.
It is often enough to examine a leech, especially its skin.
An unnatural form( narrowed in some areas and enlarged in others), the presence of nodulation on the skin, its lethargy and flabbiness, the presence of gluey mucus, a yellowish color indicate various diseases.
But even if the leeches look healthy, it will not be superfluous to make an additional simple test - put the hand in the reservoir with leeches. Healthy leeches will immediately attach to it. If the leech at the same time from time to time regurgitates, it can not be used for treatment.
Another simple test of their condition is placing leeches in a container with a lot of water. Healthy individuals after 20-30 minutes, orienting themselves in the new conditions, will begin to climb the walls of the tank.
It is possible to check motor reflexes of a leech by taking it in hands and slightly squeezing it with your fingers. A healthy leech in its normal state will react to these actions by squeezing into the lump due to a strong contraction of the muscular sac. In this case, it decreases significantly in size, and its body acquires elasticity and density.
The next important step in preparing for the procedure is the correct treatment of the patient's skin just before the session. This is necessary in order to remove pathogenic bacteria, eliminate residual smells and cause blood flow to the surface of the skin. If necessary, the skin is released from the hair, that is, shaved.
The sites on which leeches are supposed to be planted are carefully wiped first with a swab soaked in alcohol, then to destroy the smell of alcohol - tampons dipped in hot water.
Also carefully wiped places adjacent to this site.
Depending on which part of the body the leeches are put on, the patient can sit( if it's the mastoid processes behind the ears), lie down or lie down.
The timing of the procedure depends on the disease and the individual condition of the patient and ranges from 30 to 90 minutes.
Leeches are taken from the container with bare hands or with special utensils( most often a test tube).In the first case, the leech is grasped by the fingers of the head part, moved to the skin to the suction site. In the second case, it is first placed in a container with which the setting takes place.
Formerly, tweezers were used when staging leeches. However, this technique causes irritation in leeches and does not provide an opportunity to properly consider them in order to assess the condition.
Recently, experts recommend to abandon the technique of moving leeches and bare hands, as they begin to wriggle and get nervous, and after landing on the skin, they crawl along it for a long time and can even refuse to suck in the necessary places.
Production is performed in strict sequence. Each next individual is transferred to the body only after the previous one has firmly attached.
After the leech has sucked, it bites the skin, and then begins to suck the blood. At this point, the skin in its head begins to contract.
Once the required amount of leeches is supplied, a thin layer of sterile cotton wool is put under them so that they can not attach to the skin of the rear sucker. In some cases, special "bait" for leeches, most often slightly sweetened with sugar, is applied to the patient's skin in places where leeches are staged.
After saturation, the leech, as a rule, falls away from the body itself. In doing so, it extracts as much blood as needed for treatment. If the leech "falls asleep", i.e. stops sucking blood and does not fall off, on its back spend with cotton wool soaked in warm water to make it suck on. In some cases, when it is necessary to conduct a small hemorrhage, leeches are removed earlier than they are saturated. To do this, apply cotton wool soaked in a weak saline solution, alcohol or iodine to the back of the leeches, and it falls off. Tear off the leech tweezers or fingers can not.
At the bite of the leech there is a wound that resembles the Latin letter Y.It is not treated with disinfectant solutions. With the correct use of leeches such wounds bleed slightly until 24 hours. However, blood from the wound should not be stopped, it leaves very little, and often it is lymph. In addition, a small blood loss after a hirudotherapy session includes a mechanism to stimulate immunity and eliminate swelling.
In order for the wound not to spoil clothes and not to be infected by infection, an aseptic bandage is applied to it. For this, a large piece of sterile cotton wool is applied to the bite site, which is then bandaged. After the dressing is soaked with blood, a new one is applied to it, without removing the old one.
If more than 4 leeches are used, after the session, the patient should observe bed rest for 1-2 days. In other cases, bed rest is not necessary, but physical exertion for 24-48 hours should be avoided.
Despite the fact that hirudotherapy is one of the safest methods of treatment, various complications can arise after the procedure. They are caused by a number of factors. In addition to people who are contraindicated in treatment with leeches, there are patients who have a special sensitivity of the skin, which as a result of this effect can respond to various inflammatory processes( suppuration, boils, etc.).
In most cases, complications are caused by non-compliance with the basic rules for the use of leeches, such as poor skin treatment before the procedure or non-compliance with skin hygiene after it, combing the bite site, using leeches, and non-compliance after the session.
Often, complications arise due to the incorrect combination of hirudotherapy and the intake of various medications and physiotherapy procedures. Even if the leeches are performed only once, you can take medication and perform physiotherapy procedures no earlier than 1-4 days.
After the procedure, leeches are destroyed. Their secondary use is unacceptable.
It is also impossible to take general baths for 5-6 days. Otherwise, it can be entered into an infection that has not healed.
In any case, the appointment of hirudotherapy sessions, the number of leeches, the places where they are put on the body and the procedure, the timing of the return to receiving other medications and other procedures should be established only by qualified