Algorithmic approach to the prevention of unnecessary fasciotomy in extremity snake bite

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dc.authoridTurkmen, Arif/0000-0001-8774-830X
dc.authoridtemel, metin/0000-0002-1829-9894
dc.contributor.authorTurkmen, Arif
dc.contributor.authorTemel, Metin
dc.date.accessioned2024-09-18T19:50:22Z
dc.date.available2024-09-18T19:50:22Z
dc.date.issued2016
dc.departmentHatay Mustafa Kemal Üniversitesien_US
dc.description.abstractBackground: In the literature, there is a lack of a consensus about the occurrence of the compartment syndrome due to the snake bites. There are different concepts for the surgical treatment of the threshold value of the chamber pressure. There are many different classifications and assessment criteria for the snakebites. Purpose: There is not any appropriate classification in order to the assessment of extremity snake bites while making a decision for fasciotomy. We aimed to standardize the follow-up and decision making to perform fasciotomy with a new classification system for the snakebites using objective data. Patients and methods: The data of all patients were recorded prospectively between 2006 and 2011. A total of 97 patients (64 male, 33 female) with a mean age of 30.94 +/- 14.04 were followed-up. During the evaluation of the patients, we used a new classification system that was improved for the extremity bites. We classified the patients due to their signs into four groups as for the classification system. Results: 40 patients with compartment like symptoms were carefully followed for 48-72 h, and only three patients required fasciotomy where full recovery was achieved in 37 patients. Coverage of the defects was performed with full thickness skin grafting in 4 patients and cross finger flap in two patient. In two patients, the defects were located on the palmar aspect of the thumb. Thus, we applied Kite flap for skin coverage. Reverse dorsal digital artery flap was performed in eight patients and dorsal interosseous metacarpal flap in six patients. Four patients underwent an amputation. Two patients had web reconstruction due to first web contracture. Conclusions: We present a large series of snake bite injuries and propose a classification and treatment recommendations. Fasciotomy should only be done while the measurement of intra-compartment pressure is above 55 mm Hg as snakebite can mimic the compartment syndrome. Level of evidence: III-IV. (C) 2016 Elsevier Ltd. All rights reserved.en_US
dc.identifier.doi10.1016/j.injury.2016.10.023
dc.identifier.endpage2827en_US
dc.identifier.issn0020-1383
dc.identifier.issn1879-0267
dc.identifier.issue12en_US
dc.identifier.pmid27810154en_US
dc.identifier.scopus2-s2.0-85003583812en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage2822en_US
dc.identifier.urihttps://doi.org/10.1016/j.injury.2016.10.023
dc.identifier.urihttps://hdl.handle.net/20.500.12483/7396
dc.identifier.volume47en_US
dc.identifier.wosWOS:000390543800037en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofInjury-International Journal of The Care of The Injureden_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAdder biteen_US
dc.subjectSnake biteen_US
dc.subjectCompartment syndromeen_US
dc.subjectFinger defecten_US
dc.subjectRevers dorsal metacarpal flapen_US
dc.subjectEnvenoming managementen_US
dc.titleAlgorithmic approach to the prevention of unnecessary fasciotomy in extremity snake biteen_US
dc.typeArticleen_US

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