Snakebite: Management Controversies

In rural areas where venomous snakes are common, dealing with snakebite is important. However, the definitive treatment of snakebite is a subject of much controversy. The literature is contradictory and anecdotal with conclusions being drawn from animal experiments and uncontrolled clinical trials....

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Main Author: L. Pantanowitz
Format: Article
Language:English
Published: AOSIS 1998-01-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/2277
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author L. Pantanowitz
author_facet L. Pantanowitz
author_sort L. Pantanowitz
collection DOAJ
description In rural areas where venomous snakes are common, dealing with snakebite is important. However, the definitive treatment of snakebite is a subject of much controversy. The literature is contradictory and anecdotal with conclusions being drawn from animal experiments and uncontrolled clinical trials. Five such controversial issues likely to confront the rural doctor are explored. 1. Four types of tourniquet have been utilised to retard the absorption of venom with proponents both for and against their use. They have proved both beneficial and ineffectual after bites. 2. Controversy also exists regarding the use of snake anti-venom for cytotoxic snakebites. Those favouring pre-necrotic surgical excision believe that anti-venom is ineffective in preventing local tissue necrosis due to the limited local bioavailability of antivenom. 3. The use of routine antibiotics in snakebite injuries is also obscure. Those advocating early antimicrobial therapy recommend antibiotics to cover the mixed oral flora of snakes. 4. Guidelines for the treatment of children are lacking. In addition, the dose of anti-venom to be administered to children is subject to controversy. 5. Finally, management of the gravid victim remains controversial and little is known about the effects of snake venom on the foetus and pregnancy. Research to resolve such controversies will positively contribute to a dramatic fall in mortality and morbidity from snakebites.
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spelling doaj-art-26def1bd5b8346f495a5f57e5357a86d2025-08-20T04:03:17ZengAOSISSouth African Family Practice2078-61902078-62041998-01-0119110.4102/safp.v19i1.22771800Snakebite: Management ControversiesL. Pantanowitz0University of the WitwatersrandIn rural areas where venomous snakes are common, dealing with snakebite is important. However, the definitive treatment of snakebite is a subject of much controversy. The literature is contradictory and anecdotal with conclusions being drawn from animal experiments and uncontrolled clinical trials. Five such controversial issues likely to confront the rural doctor are explored. 1. Four types of tourniquet have been utilised to retard the absorption of venom with proponents both for and against their use. They have proved both beneficial and ineffectual after bites. 2. Controversy also exists regarding the use of snake anti-venom for cytotoxic snakebites. Those favouring pre-necrotic surgical excision believe that anti-venom is ineffective in preventing local tissue necrosis due to the limited local bioavailability of antivenom. 3. The use of routine antibiotics in snakebite injuries is also obscure. Those advocating early antimicrobial therapy recommend antibiotics to cover the mixed oral flora of snakes. 4. Guidelines for the treatment of children are lacking. In addition, the dose of anti-venom to be administered to children is subject to controversy. 5. Finally, management of the gravid victim remains controversial and little is known about the effects of snake venom on the foetus and pregnancy. Research to resolve such controversies will positively contribute to a dramatic fall in mortality and morbidity from snakebites.https://safpj.co.za/index.php/safpj/article/view/2277snakebiterural areatreatment
spellingShingle L. Pantanowitz
Snakebite: Management Controversies
South African Family Practice
snakebite
rural area
treatment
title Snakebite: Management Controversies
title_full Snakebite: Management Controversies
title_fullStr Snakebite: Management Controversies
title_full_unstemmed Snakebite: Management Controversies
title_short Snakebite: Management Controversies
title_sort snakebite management controversies
topic snakebite
rural area
treatment
url https://safpj.co.za/index.php/safpj/article/view/2277
work_keys_str_mv AT lpantanowitz snakebitemanagementcontroversies