Abstract

LEECHING (HIRUDOTHERAPY) IN DIABETIC FOOT ULCER, A BETTER OPTION TO AVOID AMPUTATION - CASE STUDY

Minhaj Ahmad*

ABSTRACT

About 35 million of people of India suffering from diabetes mellitus, and in future estimation it will reach more than 80 million in 2030.[1,2] Approximately 15% of them suffer from common complication of this disease. Diabetic ulcer/diabetic foot ulcer is one of the most common complication of diabetes mellitus. The annual incidence of ulcers among people with diabetes mellitus is 2.5-10.7% in developed countries, and the annual incidence of amputation for any reason is 0.25-1.8% in developing countries. Majority of people with diabetes are in the age group of 45 to 64-year.[3] Diabetic foot is a very big social, psychological, physical, economical and medical problem to the patient as well as to the surgeons. The diabetic foot ulcer usually covered with dead tissue, skin and slough which prevents healing of ulcer and further glucose loaded tissues makes it worse by providing good medium for the growth of bacteria, leading to septicaemia. In diabetes mellitus there are certain important factors which promotes ulceration such as.(1) Increased glycosylated haemoglobin decreases the oxygen dissociation.(2) Increased glycosylated tissue protein decreases the oxygen utilization.(3) Diabetic neuropathy involving all sensory, motor and autonomous components and associated atherosclerosis makes the matter worst.[4-7] Beside so many methods of treatment of diabetic foot ulcer in different modalities seems to be very difficult to treat them completely. Amputation is the last option of diabetic foot ulcer, and the complication of amputation such as excision of living heathy tissue, secondary haemorrhage, neuropathy and phantom limb are common. The present case report using Unani method “Leeching (Hirudotherapy)” gives an option to avoid amputation and treat the diabetic foot ulcer satisfactorily. Assessment of wound was done by graph paper and dressing and leeching was done for 50 days and assessed on every 10th day of dressing. It was observed that the wound was completely healed within 50 days of treatment.

Keywords: Diabetic Foot Ulcer, Leech Therapy, Unani Medicine, Leeching.