We report the successful use of leech therapy in the postsurgical management of an infant with acute venous congestion of an entire lower limb. Two days of constant leech therapy, followed by 5 days of intermittent application, decongested the affected tissues. There were no complications related to the leech therapy, and mild cutaneous hyperpigmentation was the only long-term complication of the acute venous congestion. The volume of the affected tissue may limit the success of leech therapy in cases of acute venous congestion in the limbs of adults. Nevertheless, the use of leeches to manage acute venous congestion of large portions of infants' bodies should be considered when surgical therapies are not feasible.
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