Snake bites in pediatric hand and their local complications.
DOI:
https://doi.org/10.35954/SM2022.41.2.4.e402Keywords:
Snake Bite Poisoning; Fasciotomy; Snake Bites; Snake Bites /Pediatric; Child; Pediatric; Compartment Syndrome; Snake Venoms.Abstract
Introduction: Ophidian bite poisoning is recognized as a public health problem by the World Health Organization. The low incidence added to the diversity of clinical presentations, ages, affected topographies, as well as the different protocols in the existing literature on some aspects of treatment, make the systematized management of these patients difficult. The aim of this work is to carry out a systematic review of the literature on snakebite in pediatric patients with hand and upper limb involvement, with emphasis on the management of loco-regional complications. In terms of importance and frequency, we highlight compartment syndrome, phlyctenas and infections.
Methodology: a literature search was carried out in MedLine/PubMed with the keywords: "Snake Bite hand Children" and "Snake Bite compartment syndrome". Articles published in the last 10 years (2012 to 2022) were included.
Results: the search for articles with the words "Snake Bite hand Children" resulted in 20 articles and the search for the words "Snake Bite compartment syndrome" resulted in 34 articles. After applying the inclusion and exclusion criteria, 30 articles were obtained for the analysis.
Conclusions: the pediatric population is more exposed to snake bites and in turn to present more severe lesions. The treatment of compartment syndrome continues to be a subject of debate. Inoculated venom can simulate a compartment syndrome that can be reversed without fasciotomies with proper treatment. Likewise, in the presence of clear symptoms and signs of compartment syndrome, fasciotomies are suggested because of the serious sequelae generated. In the event of the appearance of phlyctenas, careful unroofing of the phlyctenas would be an appropriate treatment. Most authors agree with prophylactic treatment with antibiotic therapy.
Received for review: February 2022.
Accepted for publication: May 2022.
Correspondence: Av. Italia S/N. C.P. 11600. Montevideo, Uruguay. Tel: (+598) 99121777.
Contact e-mail: lucia@cirugiaplasticapediatrica.com.uy
Contact e-mail: lucia@cirugiaplasticapediatrica.com.uyContact e-mail: lucia@cirugiaplasticapediatrica.com.uyphylactic treatment with antibiotic therapy.
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