RESUMO
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.
Assuntos
Desbridamento/métodos , Guias de Prática Clínica como Assunto , Transplante de Pele/métodos , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/cirurgia , Lesões dos Tecidos Moles/patologia , Adulto , Idoso , Antivenenos/administração & dosagem , Terapia Combinada , Síndromes Compartimentais , Gerenciamento Clínico , Edema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , República da Coreia , Estudos Retrospectivos , Índice de Gravidade de Doença , Pele/patologia , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/patologia , Venenos de Serpentes/efeitos adversos , Lesões dos Tecidos Moles/etiologia , Lesões dos Tecidos Moles/cirurgia , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
The authors describe an unusual case of a serous detachment of the fovea and decreased vision with parafoveal exudates with subsequent spontaneous resolution and return of central vision in a pregnant patient with tuberous sclerosis. To our knowledge, this is the first report of an ocular change during gestation in a patient with tuberous sclerosis.
