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Surgical implications of snakebites
Anindya Chattopadhyay1, Rishab Dev Patra, Vijaya Shenoy
1Department of Pediatric Surgery, Kasturba Medical College, Manipal, Karnataka, India. achattopadhyay@yahoo.com
Insights
Local complications from pediatric snakebites are common but often manageable with conservative treatment. Surgical intervention for necrosis, when needed, yields good results, with fasciotomy rarely required.
Area of Science:
- Pediatric Medicine
- Toxicology
- Surgical Management
Background:
- Snakebites frequently affect children, leading to local complications like necrosis and compartment syndrome.
- Limb survival can be compromised by these local issues, even when systemic effects are managed.
- There is a lack of clear guidelines for surgical intervention in pediatric snakebite cases.
Purpose of the Study:
- To evaluate the nature and timing of surgical treatments for local complications in pediatric snakebites.
- To assess the outcomes of various therapeutic approaches, including conservative and surgical methods.
Main Methods:
- Retrospective review of pediatric snakebite cases over a 6-year period.
- Detailed analysis of surgical lesions, treatments administered, and patient outcomes.
- Emphasis on the type of local therapy and its effectiveness.
Main Results:
- 44 out of 58 children required local therapy; most cases were managed conservatively.
- 28% of patients underwent debridement for local necrosis, with 5 requiring skin grafts and achieving good results.
- One child needed an above-knee amputation; surgical intervention correlated with higher antivenin doses.
Conclusions:
- Local complications of snakebites in children are frequent but generally manageable conservatively.
- Delayed excision of local necrosis leads to favorable outcomes.
- The necessity for fasciotomy in pediatric snakebite cases is infrequent.
Objective:
Snakebites are a common problem in the pediatric age group. Local complications such as necrosis and compartment syndrome threaten limb survival even after control of systemic manifestations. Few recommendations exist about the nature and timing of surgical treatment.
Methods:
A retrospective review of all children with snakebites presenting to the hospital was undertaken over a 6-year period. Records were reviewed with special emphasis on the type of surgical lesions seen and the treatment offered and their results.
Results:
44 of the 58 children required some form of local therapy. In the majority conservative treatment was successful. 28% of the patients needed debridement for local necrosis, and only 5 needed a skin graft, with good functional results over a period of 1 to 45 days. One child underwent an above knee amputation. Patients who required surgical intervention received significantly more vials of antivenin.
Conclusion:
Local complications of snakebite are frequent, but can be managed conservatively. Delayed excision of the resultant local necrosis is associated with good outcomes. The need for fasciotomy is rare.