Herida por picadura de loxosceles tratada con una matriz sintética de polímeros: nueva perspectiva en la cura avanzada de heridas complejas / Loxoceles bite wound treatment with synthetic polymer matrix

El loxoscelismo es un cuadro tóxico producido por el veneno que inoculan con su mordedura las arañas del género Loxosceles («arañas de rincón»). Puede presentarse bajo dos formas clínicas: loxoscelismo cutáneo y loxoscelismo cutáneo-visceral. En España se encuentra la especie Loxosceles rufescens, a la que se le han atribuido casos de loxoscelismo cutáneo. El loxoscelismo cutáneo se inicia con prurito, posteriormente dolor intenso y evoluciona hacia una forma necrosante más grave o bien a una forma edematosa, de mejor pronóstico, como el caso que exponemos a continuación. El diagnóstico es clínico. El tratamiento sistémico consiste en analgésicos, antihistamínicos, corticoides, antibióticos de amplio espectro y dapsona en casos graves. El tratamiento local se basa en la limpieza y el desbridamiento de la lesión y curas avanzadas para heridas complejas. No es infrecuente que requieran injerto cutáneo. El caso que exponemos es el de una joven de 18 años que sufrió la picadura o mordedura de una loxosceles en el dorso del pie y que desarrolló una necrosis de tejidos profundos en la zona. Presentó complicaciones sistémicas como leucocitosis y fiebre y también infección local y celulitis, por lo que requirió tratamiento sistémico e ingreso hospitalario y curas de terapéutica avanzada. Finalmente se ha conseguido la recuperación de la integridad cutánea en 84 días (AU)

Loxocelism is a toxic condition produces by the venom inoculated by the bit of the recluse spider (genus Loxosceles). In can appear in two clinical forms: cutaneous loxocelism and viscerocutaneous loxocelim. The species Loxoceles rufescens, found in Spain, is responsible of cases of cutaneous loxocelism. Cutaneous loxocelism starts with an itch, later giving rise to intense pain, and it later takes either a more or less severe necrotic form or an edematous form. The latter, with a better prognosis, is the one we focus on here. The diagnosis is clinical. The systemic treatment consists in analgesics, antihistamines, corticosteroids, broad-spectrum antibiotics, and dapsone in severe cases. The local treatment is based on the cleaning and debridement of the wound, and in advanced treatments for complex wounds. It is not uncommon that such wounds require skin grafting. We present the case of an 18-year female bitten by a loxosceles on the dorsal area of the foot. She developed a deep tissue necrosis in the area. She presented systemic complications such as leucocitosis, fever, local infection and cellulitis. Systemic treatment and hospitalization were required, as well as advanced therapeutic care. Finally, cutaneous integrity was restored after 84 days (AU)

Accidents caused by Phoneutria nigriventer: diagnosis and nursing interventions / Acidentes causados por Phoneutria nigriventer: diagnósticos e intervenções de enfermagem / Accidentes causados por Phoneutria nigriventer: diagnósticos e intervenciones de enfermería

Objetivo: Identificar os principais rótulos diagnósticos de enfermagem e suas respectivas intervenções de enfermagem, através das principais manifestações clínicas apresentadas pelos indivíduos intoxicados pelo veneno da aranha Phoneutria ningriventer encontradas na literatura. Método: Revisão integrativa da literatura consultada nas bases de dados PubMed e BVS, publicações impressas e sites oficiais relacionados à temática. Os rótulos diagnósticos de enfermagem foram elaborados com base na taxonomia II da North American Nursing Diagnosis Association International e o planejamento das intervenções de enfermagem de acordo com a Classificação das Intervenções de Enfermagem. Resultados: A partir dos achados, foi possível identificar oito rótulos diagnósticos e suas respectivas intervenções de enfermagem. Conclusão: Foram encontrados poucos estudos na literatura abordando as manifestações clínicas apresentadas pelos indivíduos intoxicados pelo veneno da aranha Phoneutria nigriventer e da atuação da enfermagem frente a esses casos.

Objective: To identify the main nursing diagnostic labels and the respective interventions through the main clinical manifestations presented by individuals poisoned by the venom of the spider Phoneutria nigriventer found in the literature. Method: Integrative review of literature consulted in PubMed and BVS databases, printed publications and official websites related to the theme. The nursing diagnostic labels were developed based on taxonomy II from the American Nursing Diagnosis Association International and the planning of nursing interventions in accordance with the Nursing Interventions Classification. Results: From the findings, it was possible to identify eight diagnostic labels and the respective nursing interventions. Conclusion: We found few studies addressing the clinical manifestations presented by individuals poisoned by the venom of the spider Phoneutria nigriventer and nursing performance in these cases.

Objetivo: Identificar las principales etiquetas diagnósticas de enfermería y sus respectivas intervenciones a través de las principales manifestaciones clínicas que presentan las personas intoxicadas por el veneno de la araña Phoneutria nigriventer encontradas en la literatura. Método: Revisión Integral de la literatura consultada en los bancos de datos PubMEed y BVS, publicaciones impresas y sitios web oficiales sobre el tema. Las etiquetas diagnósticas de enfermería fueron elaboradas con base en la taxonomía II de la North American Nursing Diagnosis Association International y planeamiento de las intervenciones de enfermería de acuerdo con la Clasificación de Intervenciones de Enfermería. Resultados: A través de los resultados fue posible identificar ocho etiquetas de diagnóstico y las respectivas intervenciones de enfermería. Conclusión: Se encontraron pocos los estudios de las manifestaciones clínicas que presentan las personas envenenadas por el veneno de la araña Phoneutria nigriventer y la actuación de enfermería en estos casos.

Úlcera provocada por picadura de araña. A propósito de un caso / Ulcer caused by bites of spider. Purpous of a case

Se presenta un caso de úlcera de larga evolución (más de un año), que pasa por diferentes fases y tratamientos, Su origen fue provocado por una picadura de araña(AU)

A case of ulcer of long evolution (more than one year), what happens is presented by different phases and treatment, its origin was caused by a spider bite (AU)

Black widow spider bite: a case study.

This article is a case study of a patient cared for in the hours before her death. After the patient's death, we learned the patient died of a black widow spider bite. This article sheds light on the potential seriousness of this venom and allows for more rapid detection and treatment of those who are unfortunate enough to be bitten. The authors have documented the sequence of events for the patient, outlined the care the patient received, examined the pathophysiology of the body to a spider bite, and then made a passionate appeal for other nurses who work in critical care to do the same with patients in similar situations.

Sistematização da Assistência de Enfermagem: acidente por Loxosceles gaucho / Nursing Care Sistematization: accident by Loxosceles gaucho / Sistematización de la Asistencia de Enfermería: accidente por Loxosceles gaucho

Relato de experiência realizado em um hospital de ensino, com uma paciente vítima de acidente por aranha do gênero Loxosceles gaucho. Este tipo de acidente pode ser classificado como leve, moderado e grave, o que dependerá do tempo entre o ocorrido e o atendimento. Objetivou-se aplicar a sistematização da assistência de enfermagem de forma integralizada e humanizada. Foram estabelecidos os seguintes diagnósticos de enfermagem: dor aguda, integridade da pele prejudicada, riscos para infecção, constipação e baixa auto-estima. O relacionamento terapêutico favoreceu as interações aluna/paciente e possibilitou o reconhecimento das necessidades que mereciam intervenções de enfermagem. O processo de enfermagem foi um instrumento valioso e trouxe elementos importantes para a evolução diária da paciente e adequação do planejamento, priorizando a qualidade dos cuidados.

Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of accident can be classified as mild, moderate and severe, depending on the period of time elapsed between the occurrence of the accident and the moment of care provision. We aimed at applying nursing care systematization in a comprehensive and humanized manner. The following nursing diagnoses were established: acute pain, damaged skin integrity, risks for infection, constipation and low self-esteem. The therapeutic relationship favored student/patient interactions and enabled the recognition of the needs that deserved nursing interventions. The nursing process was a valuable instrument and provided important elements for the patient's daily development and planning adjustment by prioritizing care quality.

Relato de experiencia realizado en un hospital de enseñanza, con una paciente víctima de accidente causado por araña del género Loxosceles gaucho. Este accidente puede ser clasificado como leve, moderado o grave, lo que dependerá del tiempo entre el suceso y la atención. Se pretendió aplicar la sistematización de la asistencia de enfermería de forma integral y humanizada. Se establecieron los siguientes diagnósticos de enfermería: dolor agudo, integridad de la piel perjudicada, riesgos de infección, constipación y baja autoestima; la relación terapéutica favoreció las interacciones alumna/paciente y posibilitó el reconocimiento de las necesidades que merecían intervenciones de enfermería. El proceso de enfermería fue un instrumento valioso y trajo elementos importantes para la evolución diaria de la paciente y adecuación de la planificación, lo que prioriza la calidad de los cuidados.

[Nursing Care Sistematization: accident by Loxosceles gaucho]. / Sistematização da Assistência de Enfermagem: acidente por Loxosceles gaucho.

Experience report carried out at a university hospital involving a patient victimized by an accident with a spider of the Loxosceles gaucho genus. This type of accident can be classified as mild, moderate and severe, depending on the period of time elapsed between the occurrence of the accident and the moment of care provision. We aimed at applying nursing care systematization in a comprehensive and humanized manner. The following nursing diagnoses were established: acute pain, damaged skin integrity, risks for infection, constipation and low self-esteem. The therapeutic relationship favored student/patient interactions and enabled the recognition of the needs that deserved nursing interventions. The nursing process was a valuable instrument and provided important elements for the patient's daily development and planning adjustment by prioritizing care quality.

Uninvited "guests" in patient homes.

This article reviews commonly prescribed medications used to treat insect bites or stings in a case study format. The review describes the implications of treatment for a patient with chronic kidney disease and acute hepatic obstruction who experienced an insect bite.

Brown recluse spider bite: a case study.

The case of a young man with a chronic, resistant, and unpredictable wound is described. The wound is believed to have been caused by the bite of a brown recluse spider. This article presents a brief overview of the potential sequelae of brown recluse spider bite and a pictorial review of this young man's wound during a 22-month period.

Wound assessment of the Loxosceles reclusa spider bite.

OBJECTIVE: The purpose of this study was to determine the data that are most important for nurses to recognize in the assessment of a Loxosceles reclusa (brown recluse) spider bite. Given such assessment elements, it may be possible to decrease the severity of complications and complexity of care by providing the most appropriate therapy. METHODS: This study involved a retrospective review of 39 identified patient charts. Aspects that were examined included demographics, wound assessments, and outcome data. Patients who came to the study facility within 48 hours of the bite and whose diagnosis was a probable or possible brown spider bite met inclusion criteria. RESULTS: Data analysis revealed that the majority of patients sustained bites on the extremities and that those bites produced the most commonly noted symptoms. This is the first study in which specific local and systemic symptoms have been quantified and related to the wound area. Because of varied treatment and limited follow-up, determining the relationship between wound assessment and outcome was problematic. DISCUSSION: Ongoing studies, in contrast to retrospective review, are needed to reduce the limitations of this study, such as the loss of patients to follow-up. Areas for further research include the replication of this study and detailed analysis of treatment variables in relation to wound outcome.

Insect bites and stings: managing allergic reactions.

This article concerns itself with three common reactions (local, toxic and anaphylactic) resulting from insect or arthropod bites and stings. A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours. A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings. An anaphylactic reaction may be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms). Even though most bites and stings are not serious, nurse practitioners should be aware of potential death resulting from insect sting allergy. They should teach hypersensitive patients, or patients with a history of a systemic reaction to any agent, about prophylactic measures. Tables showing the characteristics of insects that cause cutaneous lesions in humans, and measures necessary to decrease the risk of being stung, can be used as learning tools to prevent insect sting allergy. Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.