Using leeches to remove schrapnel

[sksvlad]

I know, sounds strange, let me tell you the whole story.
I was at my parents listening to my father reminiscing about his life before WWII. He was talking about my grandfather who was a close personal friend of A.A.Vishnevsky whose father was a famous surgeon with a God like reputation in the Soviet medical society. So I looked up A.A. Vishnevsky Wikipedia page https://en.wikipedia.org/wiki/Alexander_Alexandrovich_Vishnevsky, which stated that "he elaborated the new methods for treating gunshot wounds treatment on the Eastern Front of World War II, such as using leeches to remove shrapnel".
Now, I have a bit of medical training myself, but I can't come up with any plausible use of leeches to remove shrapnel. Anyone cares to help me?

 

[Dreamk]

You cannot remove the shrapnels themselves with leeches but you use leeches in these cases in two ways:
1) to remove the edema around the shrapnels and this enables to remove them more easily, and even, if they are rather superficial, inside the skin, this will help them to get out by themselves, the body bring them to surface as part of the tissue healing process - this use of leeches is still in practice today, mainly for burns and plastic surgery, where edema is a major problem
2) before antibiotics, in ww1, you used leeches, in field hospitals, to remove dead wound tissue before operating, so as to operate on a clean wound.
I do not know whether Vishnevsky was the one who invented that but I know that this technique was indeed used by British military surgeons during the First World War when dealing with shrapnels wounds. This effect of leeches may be also due some anti-inflammatory property of the products secreted by the saliva of the leeches, besides their anti-coagulant properties.
BTW American POW in Vietnam used a similar technique to clean their wounds from infection by letting worm lice proliferate on their open infected wounds, knowing that they would clean the necrotic infected tissue and then, when the wound was clean, eliminating the lice by urinating upon the wounds (this would also to some extent contribute to cauterizing the wound). Lice (above all flies lice) is better than leeches in this kind of indication, as they are mainly necrophage, while leeches are mainly hematophagous .
This is called combat medicine.....