Clinical predictors of early surgical intervention in patients with venomous snakebites
Abstract Background Venomous snakebites induce tissue destruction and secondary infection; however, the optimal timing of surgical intervention for these complications remains unknown. This study assessed the clinical predictors of early surgical intervention in patients with snakebites. Methods Thi...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-023-01101-x |
| _version_ | 1797865213450518528 |
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| author | Hsiao-Yu Lu Yan-Chiao Mao Po-Yu Liu Kuo-Lung Lai Cheng-Yeu Wu Yueh-Chi Tsai Jung-Hsing Yen I.-Chen Chen Chih-Sheng Lai |
| author_facet | Hsiao-Yu Lu Yan-Chiao Mao Po-Yu Liu Kuo-Lung Lai Cheng-Yeu Wu Yueh-Chi Tsai Jung-Hsing Yen I.-Chen Chen Chih-Sheng Lai |
| author_sort | Hsiao-Yu Lu |
| collection | DOAJ |
| description | Abstract Background Venomous snakebites induce tissue destruction and secondary infection; however, the optimal timing of surgical intervention for these complications remains unknown. This study assessed the clinical predictors of early surgical intervention in patients with snakebites. Methods This retrospective study included 63 patients (45 men and 18 women) with venomous snakebites. In addition to the snake species, the demographics, affected body parts, clinical characteristics, and ultrasound findings of the patients in the surgical (32 patients) and nonsurgical (31 patients) groups were analyzed and compared. Results A higher incidence of acute compartment syndrome, local ecchymosis, skin necrosis, bullae, blisters, and fever was found in the surgical group than in the nonsurgical group, and ultrasound findings of the absence of Doppler flow were more frequently noted in the surgical group than in the nonsurgical group. After adjustment using a multivariate logistic regression model, only advanced age, Naja atra bite, local ecchymosis, and bulla or blister formation remained significant factors for surgical intervention. Furthermore, comparison of the outcomes of patients who received early (≤ 24 h) and late (> 24 h) surgical intervention revealed that the duration of continuous negative pressure wound therapy (6 vs. 15 days; P = 0.006), duration of hospital stay (13 vs. 26 days; P = 0.002), and duration of outpatient follow-up (15 vs. 36 days; P < 0.001) were significantly lower in patients who received early surgical intervention. The final reconstructive surgery was simple among the patients who received surgical intervention within 24 h of being bitten (P = 0.028). Conclusion In patients with snakebites, advanced age, high-risk clinical manifestations (e.g., local ecchymosis and bulla or blister formation), and Naja atra envenomation are predictors of surgical intervention within 24 h. |
| first_indexed | 2024-04-09T23:05:36Z |
| format | Article |
| id | doaj.art-bcc3a1a5a03d4289b4281a4ef4b558c5 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-09T23:05:36Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-bcc3a1a5a03d4289b4281a4ef4b558c52023-03-22T10:46:17ZengBMCEuropean Journal of Medical Research2047-783X2023-03-012811910.1186/s40001-023-01101-xClinical predictors of early surgical intervention in patients with venomous snakebitesHsiao-Yu Lu0Yan-Chiao Mao1Po-Yu Liu2Kuo-Lung Lai3Cheng-Yeu Wu4Yueh-Chi Tsai5Jung-Hsing Yen6I.-Chen Chen7Chih-Sheng Lai8Department of Orthopedic, Taichung Veterans General HospitalDivision of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General HospitalDivision of Infection, Department of Internal Medicine, Taichung Veterans General HospitalDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General HospitalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General HospitalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General HospitalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General HospitalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General HospitalDivision of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General HospitalAbstract Background Venomous snakebites induce tissue destruction and secondary infection; however, the optimal timing of surgical intervention for these complications remains unknown. This study assessed the clinical predictors of early surgical intervention in patients with snakebites. Methods This retrospective study included 63 patients (45 men and 18 women) with venomous snakebites. In addition to the snake species, the demographics, affected body parts, clinical characteristics, and ultrasound findings of the patients in the surgical (32 patients) and nonsurgical (31 patients) groups were analyzed and compared. Results A higher incidence of acute compartment syndrome, local ecchymosis, skin necrosis, bullae, blisters, and fever was found in the surgical group than in the nonsurgical group, and ultrasound findings of the absence of Doppler flow were more frequently noted in the surgical group than in the nonsurgical group. After adjustment using a multivariate logistic regression model, only advanced age, Naja atra bite, local ecchymosis, and bulla or blister formation remained significant factors for surgical intervention. Furthermore, comparison of the outcomes of patients who received early (≤ 24 h) and late (> 24 h) surgical intervention revealed that the duration of continuous negative pressure wound therapy (6 vs. 15 days; P = 0.006), duration of hospital stay (13 vs. 26 days; P = 0.002), and duration of outpatient follow-up (15 vs. 36 days; P < 0.001) were significantly lower in patients who received early surgical intervention. The final reconstructive surgery was simple among the patients who received surgical intervention within 24 h of being bitten (P = 0.028). Conclusion In patients with snakebites, advanced age, high-risk clinical manifestations (e.g., local ecchymosis and bulla or blister formation), and Naja atra envenomation are predictors of surgical intervention within 24 h.https://doi.org/10.1186/s40001-023-01101-xEarly surgical interventionVenomous snakebiteNaja atraAntivenomEnvenomation |
| spellingShingle | Hsiao-Yu Lu Yan-Chiao Mao Po-Yu Liu Kuo-Lung Lai Cheng-Yeu Wu Yueh-Chi Tsai Jung-Hsing Yen I.-Chen Chen Chih-Sheng Lai Clinical predictors of early surgical intervention in patients with venomous snakebites European Journal of Medical Research Early surgical intervention Venomous snakebite Naja atra Antivenom Envenomation |
| title | Clinical predictors of early surgical intervention in patients with venomous snakebites |
| title_full | Clinical predictors of early surgical intervention in patients with venomous snakebites |
| title_fullStr | Clinical predictors of early surgical intervention in patients with venomous snakebites |
| title_full_unstemmed | Clinical predictors of early surgical intervention in patients with venomous snakebites |
| title_short | Clinical predictors of early surgical intervention in patients with venomous snakebites |
| title_sort | clinical predictors of early surgical intervention in patients with venomous snakebites |
| topic | Early surgical intervention Venomous snakebite Naja atra Antivenom Envenomation |
| url | https://doi.org/10.1186/s40001-023-01101-x |
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