Snake Bite Management: A Scoping Review of the Literature

Abstract

Background: Around the world, snake bite envenomation remains an underreported human health hazard. Envenomation can cause local and systemic complications, especially when there is a lack of antivenom availability. Although there are established guidelines regarding snake bite management acute care, there is a paucity of data regarding surgical intervention and the plastic surgeon’s role treating this unique patient population. Methods: A review was conducted identifying relevant published articles involving snake bite management and treatment in PubMed and EMBASE. Results: One hundred ten articles were identified and 77 met inclusion criteria. Snake bite envenomation can result in complications that are dependent upon a variety of variables. The literature has shown the best field treatment to be timely transportation to the nearest medical facility, along with antivenom administration. The cytotoxic, hemotoxic, and neurotoxic effects of venom can cause a variety of local soft tissue and systemic complications. Surgical interventions such as fasciotomies, wound debridements, skin grafts, and tissue flaps may be necessary in these patients to optimize functional and aesthetic outcomes. Disparities in access to care in resource limited settings are discussed. Conclusions: Global health disparities and insufficient antivenom distribution create an inequality of care in snake bite patients. Plastic surgeons have an important role in managing acute and chronic complications of snake bite envenomations that can lead to improved patient outcomes.

Role of a Plastic Surgeon in the Management of Local Manifestations of Snakebite in a Tertiary Care Hospital: A Prospective Single-Center Case Series

“…Socioeconomic status and a lack of access to healthcare preclude timely treatment of snakebites in resource-limited countries resulting in higher rates of secondary complications as compared with developed countries necessitating even more the need for a plastic surgeon for management of the resulting sequelae. 2 Overall, the exact incidence of snakebites requiring some kind of formal reconstruction is unknown. In the large majority of snake envenomation cases, the services of a plastic surgeon are sought for assessment and management of the local complications of the bites for restoration of form and function.…”

“…In the large majority of snake envenomation cases, the services of a plastic surgeon are sought for assessment and management of the local complications of the bites for restoration of form and function. 2 4…”

“…Though their use is discouraged, a big number of snakebite victims still apply proximal tourniquets. 1 2 Antivenin therapy has been reported to be more effective in decreasing the incidence of local complications and the need for surgical interventions. 1 2 5…”

“…The priority in the treatment of snakebites is to manage systemic toxicity, but addressing local effects helps to further improve the overall management and the results in such cases. 2…”

Aspectos clínicos y terapéuticos del accidente ofídico en hospitales nacionales de Guatemala

“…Medicamentos utilizados en combinación con el suero antiofídico, en el tratamiento de casos de accidente ofídico (accidente ofídico) atendidos en el Hospital Regional de Escuintla entre 2008 y 2013. . Medicamento uso de antibióticos es en la terapia del accidente ofídico y tiene como propósito prevenir las infecciones bacterianas en el sitio de la mordedura, así como evitar la posibilidad de una diseminación de la infección (Muñoz y Ovares, 2010;Palappallil, 2015;Resiere et al, 2020;Russell et al, 2021). Se han aislado bacterias en la cavidad oral y el veneno de víboras de especies de Centroamérica (Artavia-León et al, 2017) y en especies de Estados Unidos de Norteamérica (Goldstein et al, 1979) e incluso se ha reportado un caso de infección por bacterias multirresistentes a antibióticos post accidente ofídico (Muhammad et al, 2018).…”