International Journal of Science and Research (IJSR) ISSN: 2319-7064 SJIF (2022): 7.942 Volume 13 Issue 1, January 2024 Fully Refereed | Open Access | Double Blind Peer Reviewed Journal www.ijsr.net Leech Therapy and its Efficacy in Management of Non-Healing Ulcers - A Review Dr. Mohammed Maaz Zakariyya 1 , Dr. Mohd Ahsan Farooqui 2 , Dr. M. A. Lateef Siddiqui 3 , Dr. Shahbaz Ahmed 4 1 P.G. Scholar, P.G. Department of Moalijat, G.N.T.C, Hyderabad, Telangana, India 2 P.G. Professor & HOD, P.G. Department of Moalijat, G.N.T.C, Hyderabad, Telangana, India 3 Assistant Professor, P.G. Department of Moalijat, G.N.T.C, Hyderabad, Telangana, India 4 Professor, P.G. Department of Moalijat G.N.T.C, Hyderabad, Telangana, India Abstract: Leech therapy is one of the most important and widely practised methods of regimental therapy used for local evacuation of morbid humours way back 3500 years also it has been suggested and successfully practiced by Greeko-Arab physicians, eminent Unani physician Ibn e Sina stated in his treatise Al Qanoon fit Tib that “Leeches evacuate blood from the deeper tissues compared to Hijama”, He mentioned its efficacy such as ear, eyes, throat and skin disorders and also plays a vital role in healing of chronic non-healing ulcers, musculoskeletal diseases, thromboembolic diseases etc. According to Unani doctrine, the efficacy of leech therapy is attributed to the analgesic and resolvent activities of leeches. However, the saliva of leech contains about 100 pharmacologically active biological substances like Hirudin, hyaluronidase etc which are vasodilators, anesthetics, anti-inflammatory etc. These substances are injected into human body while sucking the blood these properties are responsible for the analgesic, anti-inflammatory and anesthetic effects of leech therapy. Leech therapy involves an initial bite, which is usually a painless bite, followed by the sucking of 5 to 15 ml of blood. Leech therapy is also used for evacuation from the parts where Hijama and Fasd cannot be applied. In Chronic Ulcers, wound healing is a combination of Regeneration and Repair of surrounding parenchymal tissues, which includes Angiogenesis and Granulation tissue formation, these things are accelerated by the components present in Leech Saliva, by inhibiting Thrombin, Platelet aggregation and fibrinolysis. Keywords: Leech therapy, Chronic wounds, Wound healing 1. Introduction Regeneration and repair in combination plays a vital role in healing chronic non-healing ulcers such as Diabetic foot ulcer, varicose ulcer, Thromboangitis obliterate, is done by Angiogenesis & Granulation tissue formation. Chronic ulcers are challenge to wound care professional and consumers. Eminent Unani Physician Shaik ur Rayees has mentioned in his famous book Al- Qanoon Fit tib “Putrifaction in any organ gets started when there is destruction of Rooh e Haiwani” to that particular organ There are 2 reasons for destruction of Rooh e Haiwani 1) Blood Toxicity 2) Interruption in blood supply. 8 Wound healing is a dynamic and sequential process which involves exudative, proliferative and extracellular matrix remodeling phases. These phases are regulated by signaling molecules produced by a wide range of cells present in the extracellular matrix. The early stages of this process (homeostasis, inflammation and proliferation) prepare the tissues for the final, remodeling stage which can last for one year or more. Various factors affect wound healing. Most chronic wounds are ulcers associated with ischemia, venous stasis or pressure. The therapeutic measures used to promote and treat wound healing must be adjusted to the states of the various wound healing phases. 4 Medicinal Leech Therapy is a multi-faceted therapeutic concept. It comprises the biting stimulus, blood drawing and the injection of pharmacologically-active substances found in leeches' saliva into patients’ blood and tissues. It’s therapeutic effects include anti-coagulation, vasodilator which induce blood and lymph flow and reduce both inflammation and pain. The pharmaceutical profile of MLT means that therapy must be restricted to the late, remodeling phase of wound healing. 14 Ancient Unani Physician Ibn sena Stated in this Book Kulliyaat qanoon that application of leech evacuate blood more deeper tissues when compare to Hijama & Fasd. He also mentioned its efficacy in various diseases such as Skin, Ear, Eye & Throat diseases. It also plays a vital role in healing Chronic no healing ulcers. 12 It’s efficacy is also mentioned in ancient book Sushruth Samhita that Leech therapy is useful in Skin, Musculoskel et al disorders and in healing of chronic ulcers. 9 Conditions which interfere with the Healing of ulcers 1) Unhealthy condition of surrounding area 2) Deficient supply of healthy blood 3) Excessive flow of blood 4) Necrosis of the underlying bone 1 Classification of wounds Basically wounds are classified as 1) Clean & Untidy wound Paper ID: SR231228133011 DOI: https://dx.doi.org/10.21275/SR231228133011 146