Investigating the therapeutic potential of medical leech and leech saliva extract in flap survival: an in vivo study using rats

OBJECTIVES: Medicinal leeches have long been recognized for the bioactive compounds present in their saliva. These compounds have been of interest due to their potential therapeutic properties. This research aimed to explore the impact of both medicinal leech application and the application of medicinal leech saliva extract on wound healing in a rat model with a dorsal random flap METHODS: study, a dorsal random skin flap model was created in female Wistar albino rats. Rats were randomly assigned to three groups: control (flap only), medicinal leech therapy (MLT), and leech saliva extract (LSE) injection. Histological, immunohistochemical (VEGF), and ELISA-based biochemical analyses were performed to assess wound healing parameters on postoperative day 7. RESULTS: The flap necrosis area (%) in Group II and Group III was significantly lower than the control group (p<0.05). Vascular Endothelial Growth Factor (VEGF) (+) cell (%), neovascularisation, epithelial regeneration, and granulation tissue thickness in Group II and Group III were significantly higher than the control group (p<0.05). Also, inflammatory cells in group III were substantially lower than in the control group (p<0.05). CONCLUSIONS: To our knowledge, this study is the first in the literature to examine the effect of medicinal leech extract injection in the flap model. These findings emphasize the potential therapeutic benefits of medicinal leeches and their saliva extract in promoting efficient wound healing, with implications for future clinical applications.