Yonsei Med J.  2015 Sep;56(5):1443-1448. 10.3349/ymj.2015.56.5.1443.

Snakebite in Korea: A Guideline to Primary Surgical Management

• Rha JH
• Kwon SM
• Oh JR
• Han BK
• Lee KH
• Kim JH

• KMID: 2163642
• DOI: http://doi.org/10.3349/ymj.2015.56.5.1443

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 validity and 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 emergency center 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 general symptoms, 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, resulting in 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 research was safely and properly followed during surgical treatment.

Keyword

Snakebite; antivenom; severity; surgical management

MeSH Terms

Adult
Aged
Antivenins/administration & dosage
Combined Modality Therapy
Compartment Syndromes
Debridement/*methods
Disease Management
Edema/etiology
Female
Humans
Male
Middle Aged
Necrosis
*Practice Guidelines as Topic
Republic of Korea
Retrospective Studies
Severity of Illness Index
Skin/pathology
Skin Transplantation/*methods
Snake Bites/complications/*diagnosis/pathology/*surgery
Snake Venoms/adverse effects
Soft Tissue Injuries/etiology/*pathology/surgery
Treatment Outcome
Wound Healing/physiology
Antivenins
Snake Venoms

Figure

• 

  Fig. 1 Treatment protocol of snake bite.

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