Snakebite on the hand: lessons from two clinical cases illustrating difficulties of surgical indication

Abstract

Snakebite is a particularly important health problem in rural areas of tropical regions. A large number of victims survive with permanent physical sequelae due to local tissue necrosis. However, necrosis may be associated with compartment syndrome especially when the bite is on the hands or feet. Herein, we describe two cases reported at a rural district hospital in Central African Republic. The present study suggests that active multidisciplinary management may improve patient prognosis while evidencing how difficult it is to decide on surgical intervention.

Surgical Management of Snake Envenomation in Children

“…Surgical intervention is based on multidisciplinary approach not a single clinical criterion. (6) One study from Korea states that conservative approach would be the best in children with viper bites. Earlier surgical intervention in children with tissue necrosis did not yield good results and had a poor surgical outcome.…”

African Snakes

“…Over 80 % of the bites are located on the lower limb, especially below the knee, but significant geographical variations are observed. Bites to the hand are uncommon to rare, but not exceptional, especially among farmers who work with tools with a short handle or in children who dig with bare hands in burrows in search of small vertebrates to supplement their diet [53].…”

African Society of Toxinology: a new opportunity for integrating the control of envenomations in Africa

“…Presentations of clinical envenomation cases served as a reminder of the consequences, not only in relation to mortality but also disability (21,23). Therapeutic uncertainties, especially for the treatment of envenomation by Elapidae are highlighted by (24).…”