An intensive course of leech therapy has helped save the leg of a lorry driver injured in a freak accident.
David Isitt faced losing a leg
David Isitt needed more than 30 leeches over a week to suck blood out of a large skin flap on his leg where the skin was struggling to survive.
Mr Isitt, from the Isle of Dogs, faced amputation if the treatment failed - but he is now standing on both legs again, and learning to walk unaided.
The treatment was carried out at the Royal London Hospital.
Mr Isitt was injured in March when he slipped off the side of his tipper truck while checking that his cargo of concrete was secure.
The leeches come from a farm in south Wales
The specific variety, Hirudo medicinalis has 32 brains and 100 teeth in each of its three jaws
It produces a small bleeding wound that maintains venous circulation in areas where it is impaired
Its bite is painless, because it includes a local anaesthetic as well as an anticoagulant
The leech can consume up to five times its weight in blood before dropping off the patient
He fell nearly 2.5m onto the road and shattered several major bones in his right leg.
He said: "I knew straight away that I had done a lot of damage but I couldn't really feel the pain as the adrenaline must have kicked in."
He was taken by Air Ambulance to the Royal London, where he underwent the first of several major orthopaedic operations by expert surgeons to save his leg.
A final operation involved a specialist plastic surgeon moving a large skin flap to the front of Mr Isitt's leg to cover the newly repaired bone.
In complicated procedures such as this it is sometimes difficult to maintain a normal blood flow in the skin flap - and the tip of Mr Isitt's skin flap started to go blue.
Mr Isitt said: "It was really quite a worrying time. It was clear that the skin flap was not getting enough blood and I was worried the skin would die or might become infected.
"The conventional treatments didn't seem to be working and it looked like I may need to have it all removed and undergo another major operation."
'A bit surprised'
At this point that the clinical nurse specialist, Daren Edwards decided to use leeches to save the skin flap.
The animals can draw the blood away from the skin which allows it to survive long enough for the veins to start working normally again.
Mr Isitt said: "I was a bit surprised when they suggested using leeches but they are the experts so I trusted their judgement."
Within days colour returned to the skin flap but in total the leeches were needed for more than a week to restore effective circulation of the blood.
Mr Edwards said: "I've used them before but not over such a long period and that is a reflection of the seriousness of Mr Isitt's injuries.
"Without the assistance of the leeches his flap may have failed, and a more complicated reconstruction been required.
"At worst, the fracture may have become infected, and he may have lost that leg."