Amputation and disability following snakebite in Nigeria

Abstract

Snakebite is an important cause of amputation and disability in rural communities throughout the tropics. However, the details of the causes, types and estimates of disability are lacking. This report describes 16 snakebite victims who had amputations, including two who had above-knee amputations. The patients presented with limb swelling (16), gangrene (15), ischaemia (4) and three had possible compartment syndrome. All the patients used ineffective time wasting remedies that were potentially harmful as first-aid. The median delay to hospital following bite was 2.5 days. In order to prevent disability, efforts should be made to: reduce delay before hospital presentation; improve the knowledge of first-aid; provide effective antivenoms; improve wound and clinical care in communities; and improve facilities.

Snakebite Envenoming: A Public Health Perspective

“…In the case of bites by viperid snakes, and by some elapids (genus Naja) that induce local tissue necrosis, sequelae include tissue loss and dysfunction, which may lead to amputation (S.B. Abubakar et al, 2010a;Otero et al, 2002;Warrell, 2010). Despite the scarcity of statistics on the incidence of sequelae following snakebite, observations in sub-Saharan Africa indicate that up to 20% of the patients, perhaps more, develop permanent physical sequelae Snow et al, 1994).…”

Ultrasound findings in 42 patients with cytotoxic tissue damage following bites by South African snakes

“…The site and degree of swelling essentially determine the resulting pathology and clinical picture. However, the severity of the swelling and associated pain may raise the suspicion of an underlying compartment syndrome, which is described as a complication of bites of a number of species with cytotoxic venom, including African vipers,3 4 North American crotaline species5 6 and European vipers 7–10…”

Snakebite on the hand: lessons from two clinical cases illustrating difficulties of surgical indication

“…The two cases reported herein represent a relatively common situation in Africa and Asia (7)(8)(9)(10)(11). Children are particularly vulnerable when seeking food in rodent burrows or playing with what they find without understanding the hazard.…”