engleski

Local complications following venomous snakebites in southern Croatia

This retrospective study represents local complications following venomous snake bites in patients in southern Croatia, who were treated in University Hospital Centre Split during the period of 39 years (from January 1, 1976 to December 31, 2014). A total of 737 patients were registered, of which 164 were children. Local complications were found in 20% of all patients with snake bite envenomation in the following order: haemorrhagic blisters (13.5%) followed by the skin and muscle necrosis (4%), thrombophlebitis (2%), compartment syndrome (CS) (2%) and infections (1%). Heamorrhagic blisters were noticed in different sizes, from size of a pea to the size of a walnut and even larger. In most cases, the incision of a haemorrhagic blister was performed. Early debridement was performed only when the skin and muscles necrosis were extensive. Thrombophlebitis of the blood vessels near the bite site occured more often in the elderly, as well as in cases in which the bite was in the leg. The most serious local complication — CS, occured mostly in children, and upper extremities were more affected than lower extremities. In the overall of the 15 (2%) CS cases, there were three cases in adults, and even 12 of them in children. Massive swelling at the bite site leads to increased tissue pressure within the closed bonefascial space of the extremity, which leads to the development of CS. This usually occurs in children in which envenomation is usually more severe due to the inoculation of higher quantity of venom per unit of body weight. Fasciotomies were performed in all cases of CS.

local complications ; venomous snake bites ; southern Croatia

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