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KMID : 0378019660090040098
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New Medical Journal
1966 Volume.9 No. 4 p.98 ~ p.107
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Surgical Experience in Snake-Bite
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李龍海/Lee, Yong Hae
李會白/나규연/金榮祐/Lee, Hoi Paik/Lah, Kyu Youn/Kim, Young U
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Abstract
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In 1962 Amorel, et al reported that approximately 30,000 to 40,000 people die per year of the effects of snake-bite and about 85 percent of these deaths occur in South East Asia and South Asia. The mortality rate was reduced from 30 percent to below 5 percent because of modern development of surgical treatment. Forty-seven cases of snake-bite treated at the Wonju Union Christian Hospital for the past five years covering 1961-1965 are reported. The most commonly seen poisonous snakes were Ancistrodon Halyx Brevicaudus Stejneger, Ancistro don Halyx Intermedius Strauch, and Ancistrodon Blomhoffi. The venin of these snakes consist mainly of cytolysin which produce tissue necrosis, hemorhage, hemolysis and destruction of endothelial. lining cells of blood vessels. The most common clinical manifestations were ecchymosis, subcutaneous hemorrhage, blister formation and skin erosion. However, by faulty use of tourniquets further complications such as skin necrosis, muscle or bony necrosis were seen. Typical toxic general manifestations caused by neurotoxin were not observed in our series.
Treatment consisted of general supportive care and local care. The fresh snake-bite wound was treated by incision and suction and saline soaking. Complicated wounds such as skin necrosis were treated by debridement, and skin graft. Bony necrosis was treated by amputation. Antivenin was not availlable for use. There was no mortality among our series. The amajor complications of snake-bite were due more to the faulty or prolonged tourniquet use and home treatment than to the snake-bite itself.
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