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Bedside Bloodletting

Avi Friedman

Leeches? Isn’t that so Dark Ages? Apparently not, according to Hadassah Hospital’s Dr. Kosta Y. Mumcuoglu, who uses the parasite to help accident victims in danger of losing a finger or toe. The leech makes a comeback.

Wednesday, March 06, 2013

Bruchi Ruzitsky wasn’t sure what to expect on October 25, 2012, but as morning dawned her medical condition didn’t look good. The previous day she had severed 90 percent of her left pinkie finger in a gardening accident, but she says she was misdiagnosed when she arrived at the emergency room atJerusalem’sHadassah–HebrewUniversityMedicalCenterat Ein Kerem. Nearly 22 hours after the accident, the finger had started to turn blue, a sign that necrosis had begun to set in. It appeared that doctors would have to amputate.

Ruzitsky understood that the finger was likely to require major surgery, and she had even started to come to terms, emotionally, with the idea of amputation. But she was totally unprepared for the reaction she got from Dr. Carole Pidhorz, a hand specialist at the hospital, who arrived just after seven in the morning.

“Bring me some leeches,” said the doctor.

A mere 15 minutes later, Dr. Kosta Y. Mumcuoglu arrived with two leeches in a jar and asked Dr. Pidhorz for a syringe. Mumcuoglu, a parasitologist at theHebrewUniversitymedical school, snipped off the end of the tube, stuffed in a leech, carefully placed the syringe on Ruzitsky’s wounded finger and applied the leech to the site of the wound. A minute later he repeated the procedure with a second leech. The animals did what comes naturally: They sucked her blood.

In less than an hour, the treatment appeared to be working: A pinkish-white color had started to return to the finger, a sign that enough blood had returned to the finger to begin the healing process.  That process took five more days, but eventually doctors were able to surgically reattach the finger and to begin rehabilitation.

“At first I was horrified by the word ‘leeches,’ ” said Ruzitsky in early January, two months after the accident. “The idea of bloodletting reminded me of a sordid procedure in a 13th-century dungeon, not a 21st-century medical hospital.

“But I had very few options. They’d gotten it wrong at the emergency room — the first doctor who examined me was a plastic surgeon who thought the wound was mainly cosmetic. He gave me two stitches and sent me home, but in reality I’d severed all the veins and arteries leading into the finger. So by the time I saw Dr. Pidhorz they’d lost the momentum to save the finger. It sounded awful but I was willing to do just about anything to save my finger.” 

After the treatment started, Ruzitsky was able to relax. Of course, the injury looked terrible, and she said the experience of watching two leeches latch on to her finger was “surreal.” But she also said the treatment didn’t hurt at all because she’d severed all the nerves into the finger, and she had plenty of time to inquire about the physiology of a leech and to hear about their medical use inIsraeltoday. 

“The first one stayed on for 45 minutes, which is about the normal amount of time. The second one stayed on for four-and-a-half hours, which is a very long time,” she said. “By that time the blood had started to revive the finger.”

 

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