Leech management before application on patient: a nationwide survey of practices in French university hospitals

Abstract : Background Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. Methods Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. Results Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%), but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2), sulfamethoxazole/trimethoprim (2) or amoxicillin/clavulanic acid (1). Conclusions Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.
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Contributeur : Mélanie Karli <>
Soumis le : samedi 20 avril 2019 - 15:41:11
Dernière modification le : mercredi 3 juillet 2019 - 11:36:03

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Delphine Grau, Raphaël Masson, Maxime Villiet, Brigitte Lamy. Leech management before application on patient: a nationwide survey of practices in French university hospitals. Antimicrobial Resistance and Infection Control, BioMed Central, 2018, 7 (1), ⟨10.1186/s13756-018-0311-7⟩. ⟨hal-02105267⟩



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