Snakebite in Korea: A Guideline to Primary Surgical Management
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Purpose: Snakebite is an emergency which causes local symptoms such as pain and edema around the bite. Systemic symptoms may also develop, such as dizziness or renal failure, and may even cause death. The purpose of this research was to assess the validityand safety of snakebite protocol for surgery when treating snakebite patients. Materials and Methods: Retrospective research was performed on patients who were admitted after being treated at the emergencycenter from January 2008 to December 2012. When necessary, debridement was also performed, and 46 of 111 patients (41.4%) underwent debridement. Those who had received debridement without antivenom administration due to a positive skin reaction test were classified as group A, and group B received antivenom and delayed debridement. We reviewed the emergency and admission charts of the patients in each group and recorded and compared their age, sex, bite site, severity of local and generalsymptoms, time to receive antivenin, and complications. Results: Of the ten patients (21.7%) in group A, two (66.6%) developed cellulites, and one of them experienced skin necrosis, resultingin a skin graft. In group B, there were 36 patients (78.2%), 19 (52.7%) of whom developed cellulitis. Skin necrosis occurred in two patients, and one of these patients received a skin graft. Compartment syndrome was found in one patient, and fasciotomy and a skin graft were performed. Conclusion: The treatment protocol implemented to treat snakebite patients admitted to the emergency center during this researchwas safely and properly followed during surgical treatment.
Abstract
Purpose: Snakebite is an emergency which causes local symptoms such as pain and edema around the bite. Systemic symptoms may also develop, such as dizziness or renal failure, and may even cause death. The purpose of this research was to assess the validityand safety of snakebite protocol for surgery when treating snakebite patients. Materials and Methods: Retrospective research was performed on patients who were admitted after being treated at the emergencycenter from January 2008 to December 2012. When necessary, debridement was also performed, and 46 of 111 patients (41.4%) underwent debridement. Those who had received debridement without antivenom administration due to a positive skin reaction test were classified as group A, and group B received antivenom and delayed debridement. We reviewed the emergency and admission charts of the patients in each group and recorded and compared their age, sex, bite site, severity of local and generalsymptoms, time to receive antivenin, and complications. Results: Of the ten patients (21.7%) in group A, two (66.6%) developed cellulites, and one of them experienced skin necrosis, resultingin a skin graft. In group B, there were 36 patients (78.2%), 19 (52.7%) of whom developed cellulitis. Skin necrosis occurred in two patients, and one of these patients received a skin graft. Compartment syndrome was found in one patient, and fasciotomy and a skin graft were performed. Conclusion: The treatment protocol implemented to treat snakebite patients admitted to the emergency center during this researchwas safely and properly followed during surgical treatment.
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