We’ve been absent for weeks and for good reason – moved back to NYC, started a new job, and, getting back into the rhythm of things has taken longer than anticipated. So, we decided we would return to leeches.

Yes, those creepy little worms with the strong, sucking teeth with an insatiable appetite for blood.

Twice this month, the medical use of leeches has appeared in the news. First, the New York Times reported Age-Old Cures, Like the Maggot, Get U.S. Hearing how maggots and leeches in medical use are experiencing “a quiet renaissance among high-tech surgeons.”

Leeches, you may be interested to know:

are particularly good at draining excess blood from surgically reattached or transplanted appendages. As microsurgeons tackle feats like reattaching hands, scalps and even faces, leeches have become indispensable.

Why? Because:

Leeches naturally inject patients with a potent chemical cocktail that includes an anticoagulant, an anesthetic, an antibiotic and a substance that dilates blood vessels. This cocktail encourages fast bleeding to empty the appendage of extra blood, reducing pressure and allowing veins to form on their own.

What was interesting about Times article was the fact that:

neither leeches nor maggots have ever been subject to thorough regulation by the Food and Drug Administration. So the medical advisers are being asked to create general guidelines about how they should be safely grown, transported and sold.

In addition, the article discussed the medical use of maggots.

We had no idea.

The Virginia’s Daily Progress’ Leeches Help UVa Doctors” repeats a lot of the same facts in the NYTimes article, but spinned it Virginia-style. However, the article offers more information on the FDA:

In June, the FDA granted clearance for one French company to commercially market leeches as medical devices. Since then, the FDA has been working to classify the risk-level of leeches, a process that Julie Zawisza, a spokeswoman for the FDA, describes as “a housekeeping chore.”
Leeches have been under FDA control since the 1976 Food, Drug and Cosmetic Act. Because of their long history, however, the FDA never classified them, but only grandfathered them into the law. As unclassified devices, they were automatically deemed Class Three or high risk devices, Zawisza explained.
“Class Three doesn’t make any sense to us,” Zawisza said. “We know a lot about them; we know they’re safe.”
While leeches are still unclassified, a panel of experts has recommended that they be Class Two medical devices, Zawisza said. The classification would include special controls, including a mandatory guidance document and a prescription requirement.

Leeches and maggots in medicine fascinate us because they are so retro. Look for more posts on this in the future.