Cases with periodic increase: Approach to snakebites in plastic surgery

Snakebites in plastic surgery

Abstract

Background/Aim: Snakebite injuries are common in rural areas, particularly among individuals involved in outdoor activities. In Kahramanmaras, Turkey, snakebites may be considered an occupational hazard, especially for cotton pickers.
Methods: This retrospective case series includes 20 snakebite patients who were consulted by the Department of Plastic, Reconstructive, and Aesthetic Surgery at Kahramanmaras Sutcu Imam University Hospital. Patient data were collected retrospectively between 2020 and 2022.
Results: The majority of the patients were male (60%, n = 12), while 40% (n = 8) were female. The mean age of the patients was 38.15 years. The mean D-dimer level was 16.02 units, with a range of 1.12–80 units. The mean platelet count was 175,220/µL, with a range of 65,000–325,000/µL. Upper limb involvement was the most common, observed in 65% of cases, compared to 35% with lower extremity involvement. In 60% of the cases, relaxation incisions were performed, while 40% of the patients were managed conservatively. The mean duration of ICU stay and hospitalization in the plastic surgery ward were 3.7 days and 3.55 days, respectively. Two patients developed complications other than scarring: One developed subclavian vein thrombosis, and another developed finger bone necrosis requiring amputation.
Conclusion: Snake venom contains a variety of enzymes and toxins that cause not only local tissue damage but also systemic effects. In cases of snakebite, a multidisciplinary approach is essential—beginning with field management and involving a team that includes emergency physicians, internal medicine specialists, anesthesiologists, psychiatrists, and plastic surgeons—to address both the physical and psychological needs of the patient. Importantly, early surgical consultation can help prevent severe complications.