Received: July 11, 2008.

Accepted: January 1, 2009.

Abstract published online: February 17, 2008.

Full paper published online: February 28, 2009.

IMMEDIATE RADICAL FANG MARK ABLATION MAY ALLOW TREATMENT OF JAPANESE VIPER BITE WITHOUT ANTIVENOM

Fujioka M (1), Oka K (1), Kitamura R (1), Yakabe A (1), Ito M (2)

(1) Department of Plastic and Reconstructive Surgery, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan; (2) Department of Pathology, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan.

ABSTRACT: Administration of antivenom is currently the standard treatment for snake envenomation. However, it can sometimes cause anaphylactic reactions including urticaria, bronchospasm and hypotension. Furthermore, it may also provoke life-threatening complications, even though the mortality rate is less than 1%. In this study, we present a new treatment – immediate radical fang mark ablation – that was successfully performed on five victims of Japanese viper bites without antivenom use. In these five victims of venomous snakebites, surgical debridement was immediately performed. Two patients received a free-skin graft to resurface their wounds while three of them healed conservatively (i.e. by ointment  treatment without surgery). After treatment, all patients could return to work. Immediate radical ablation is a recommended procedure that can reduce the amount of venom in tissues, which consequently decreases inflammatory reactions and reduces the necessity for antivenom.

KEY WORDS: ablation, viper bite, antivenom, fang mark, envenomation.

CONFLICTS OF INTEREST: There is no conflict.

CORRESPONDENCE TO:

MASAKI FUJIOKA, Department of Plastic and Reconstructive Surgery, Nagasaki National Medical Center, 1001-1, Kubara 2, Ohmura City, 856-8562, Japan. Phone: 0957 52 3121. Fax: 0957 54 0292. Email: mfujioka@nmc.hosp.go.jp.