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

Gras S (1), Plantefève G (2), Baud F (1), Chippaux JP (3, 4)

(1) Department of Medicine, Doctors Without Borders, Paris, France; (2) Polyvalent Reanimation Service, Victor Dupouy Hospital Center, Argenteuil, France; (3) Center for the Study and Research of Malaria Associated with Pregnancy and Childhood (Cerpage), Cotonou, Benin; (4) Institute of Research for Development (IRD - UMR 216 "Mother and child facing tropical diseases"), Cotonou, Benin.

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.

Key words: snakebite, Africa, compartment syndrome, surgery.

COPYRIGHT

© CEVAP 2012

SUBMISSION STATUS

Received: September 19, 2012.

Accepted: October 23, 2012.

Abstract published online: October 29, 2012.

Full paper published online: November 30, 2012.

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

FINANCIAL SOURCE

The study was supported by Médecins Sans Frontières (French NGO "Doctors Without Borders").

ETHICS COMMITTEE APPROVAL

The present descriptive study based on medical records of Paoua Hospital was approved by CAR Ministry of Health.

CORRESPONDENCE TO

Séverine Gras, Département Médical, Médecins Sans Frontières, 8 rue Saint Sabin, 75011 Paris, France. Email: severine.gras@gmail.com.