Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia
Background Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgica...
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| Veröffentlicht in: | World journal of surgery 2022-01, Vol.46 (1), p.54-60 |
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| creator | Uy, Kim Heang, Oy Keo, Vanna Kim, Yong June Gollogly, Jim Lee, Ling Hong |
| description | Background
Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite-related musculoskeletal injuries at Children’s Surgical Centre, Phnom Penh, Cambodia.
Methods
We conducted a retrospective case series analysis of patients with snakebite-related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= one year, respectively) based on their time interval from snake bite to time of presentation.
Results
There were 88 patients who presented with snakebite-related musculoskeletal injury during the cohort study period. Majority of them were male (
n
= 62, 71%) and had a median age of 24 years old (IQR 17–44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher’s test
p
= 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months–11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher’s test
p
|
| doi_str_mv | 10.1007/s00268-021-06307-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2572940215</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2610661121</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3772-fd2938573c09b6bf63dfd1146cada66f0ef6fd10235824783b0a1f4930556683</originalsourceid><addsrcrecordid>eNqNkcFu1DAQhi0EokvhBTggS1y4BMZ24mS5lVULRa1AbCWOlpOMF7eOs7UdLb3BM_CGfZK6pIDEAXHyaPR9v0b-CXnK4CUDqF9FAC6bAjgrQAqoi909smCl4AUXXNwnCxCyzDMTe-RRjOcArJYgH5I9UVZcQCkX5Pt6ChvbaUdPtdcbHNAnOhr6USebx0h3Nn2ha68vsLUJi0_odMKenk6xm9wYL9BhyvZqHLYu5yQ7-utvPw7o2vqNQ3rsY7Jpul3Tw69bDDm1Q2o9XemhHXurH5MHRruIT-7efXJ2dHi2elecfHh7vDo4KTpR17wwPV-KpqpFB8tWtkaK3vSMlbLTvZbSABqZF8BF1fCybkQLmplyKaCqpGzEPnkxx27DeDlhTGqwsUPntMdxiopXNV-W-S-rjD7_Cz0fp-DzcYpLBlIyxlmm-Ex1YYwxoFHbYAcdrhQDdduPmvtROVP97EftsvTsLnpqB-x_K78KycDrGdhZh1f_Eak-v1-_OQImGM-ymOWYPb_B8Ofwf9x0A-uirpY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2610661121</pqid></control><display><type>article</type><title>Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Uy, Kim ; Heang, Oy ; Keo, Vanna ; Kim, Yong June ; Gollogly, Jim ; Lee, Ling Hong</creator><creatorcontrib>Uy, Kim ; Heang, Oy ; Keo, Vanna ; Kim, Yong June ; Gollogly, Jim ; Lee, Ling Hong</creatorcontrib><description>Background
Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite-related musculoskeletal injuries at Children’s Surgical Centre, Phnom Penh, Cambodia.
Methods
We conducted a retrospective case series analysis of patients with snakebite-related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= < one year vs. > one year, respectively) based on their time interval from snake bite to time of presentation.
Results
There were 88 patients who presented with snakebite-related musculoskeletal injury during the cohort study period. Majority of them were male (
n
= 62, 71%) and had a median age of 24 years old (IQR 17–44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher’s test
p
= 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months–11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher’s test
p
< 0.0001). For management, surgical debridement was the most common primary intervention for the early group (52% vs. 19%), and contracture release was the most common for patients in the late group (62% vs. 15%) (Fisher’s test
p
= 0.0004). Overall, the postoperative complication rate was highest in the late presenting group (34% vs. 3%, Fisher’s test
p
= 0.005).
Conclusion
More than half of the patients presented with musculoskeletal injury require surgical correction. Our study demonstrated that scar contracture is the most common complaint among the late presenting group and is associated with high postoperative complication rate.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-021-06307-w</identifier><identifier>PMID: 34523046</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Cambodia - epidemiology ; Cardiac Surgery ; Child ; Cicatrix ; Cohort Studies ; Complications ; Female ; General Surgery ; Humans ; Injuries ; Injury analysis ; Male ; Medicine ; Medicine & Public Health ; Patients ; Postoperative ; Public health ; Rehabilitation ; Retrospective Studies ; Snake bites ; Snake Bites - complications ; Snake Bites - epidemiology ; Surgery ; Surgery in Low and Middle Income Countries ; Thoracic Surgery ; Vascular Surgery ; Venom ; Young Adult</subject><ispartof>World journal of surgery, 2022-01, Vol.46 (1), p.54-60</ispartof><rights>Société Internationale de Chirurgie 2021</rights><rights>2022 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2021. Société Internationale de Chirurgie.</rights><rights>Société Internationale de Chirurgie 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3772-fd2938573c09b6bf63dfd1146cada66f0ef6fd10235824783b0a1f4930556683</cites><orcidid>0000-0002-3313-035X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-021-06307-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-021-06307-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,41469,42538,45555,45556,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34523046$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uy, Kim</creatorcontrib><creatorcontrib>Heang, Oy</creatorcontrib><creatorcontrib>Keo, Vanna</creatorcontrib><creatorcontrib>Kim, Yong June</creatorcontrib><creatorcontrib>Gollogly, Jim</creatorcontrib><creatorcontrib>Lee, Ling Hong</creatorcontrib><title>Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite-related musculoskeletal injuries at Children’s Surgical Centre, Phnom Penh, Cambodia.
Methods
We conducted a retrospective case series analysis of patients with snakebite-related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= < one year vs. > one year, respectively) based on their time interval from snake bite to time of presentation.
Results
There were 88 patients who presented with snakebite-related musculoskeletal injury during the cohort study period. Majority of them were male (
n
= 62, 71%) and had a median age of 24 years old (IQR 17–44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher’s test
p
= 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months–11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher’s test
p
< 0.0001). For management, surgical debridement was the most common primary intervention for the early group (52% vs. 19%), and contracture release was the most common for patients in the late group (62% vs. 15%) (Fisher’s test
p
= 0.0004). Overall, the postoperative complication rate was highest in the late presenting group (34% vs. 3%, Fisher’s test
p
= 0.005).
Conclusion
More than half of the patients presented with musculoskeletal injury require surgical correction. Our study demonstrated that scar contracture is the most common complaint among the late presenting group and is associated with high postoperative complication rate.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Cambodia - epidemiology</subject><subject>Cardiac Surgery</subject><subject>Child</subject><subject>Cicatrix</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Postoperative</subject><subject>Public health</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Snake bites</subject><subject>Snake Bites - complications</subject><subject>Snake Bites - epidemiology</subject><subject>Surgery</subject><subject>Surgery in Low and Middle Income Countries</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><subject>Venom</subject><subject>Young Adult</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkcFu1DAQhi0EokvhBTggS1y4BMZ24mS5lVULRa1AbCWOlpOMF7eOs7UdLb3BM_CGfZK6pIDEAXHyaPR9v0b-CXnK4CUDqF9FAC6bAjgrQAqoi909smCl4AUXXNwnCxCyzDMTe-RRjOcArJYgH5I9UVZcQCkX5Pt6ChvbaUdPtdcbHNAnOhr6USebx0h3Nn2ha68vsLUJi0_odMKenk6xm9wYL9BhyvZqHLYu5yQ7-utvPw7o2vqNQ3rsY7Jpul3Tw69bDDm1Q2o9XemhHXurH5MHRruIT-7efXJ2dHi2elecfHh7vDo4KTpR17wwPV-KpqpFB8tWtkaK3vSMlbLTvZbSABqZF8BF1fCybkQLmplyKaCqpGzEPnkxx27DeDlhTGqwsUPntMdxiopXNV-W-S-rjD7_Cz0fp-DzcYpLBlIyxlmm-Ex1YYwxoFHbYAcdrhQDdduPmvtROVP97EftsvTsLnpqB-x_K78KycDrGdhZh1f_Eak-v1-_OQImGM-ymOWYPb_B8Ofwf9x0A-uirpY</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Uy, Kim</creator><creator>Heang, Oy</creator><creator>Keo, Vanna</creator><creator>Kim, Yong June</creator><creator>Gollogly, Jim</creator><creator>Lee, Ling Hong</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3313-035X</orcidid></search><sort><creationdate>202201</creationdate><title>Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia</title><author>Uy, Kim ; Heang, Oy ; Keo, Vanna ; Kim, Yong June ; Gollogly, Jim ; Lee, Ling Hong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3772-fd2938573c09b6bf63dfd1146cada66f0ef6fd10235824783b0a1f4930556683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Cambodia - epidemiology</topic><topic>Cardiac Surgery</topic><topic>Child</topic><topic>Cicatrix</topic><topic>Cohort Studies</topic><topic>Complications</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Postoperative</topic><topic>Public health</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Snake bites</topic><topic>Snake Bites - complications</topic><topic>Snake Bites - epidemiology</topic><topic>Surgery</topic><topic>Surgery in Low and Middle Income Countries</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><topic>Venom</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uy, Kim</creatorcontrib><creatorcontrib>Heang, Oy</creatorcontrib><creatorcontrib>Keo, Vanna</creatorcontrib><creatorcontrib>Kim, Yong June</creatorcontrib><creatorcontrib>Gollogly, Jim</creatorcontrib><creatorcontrib>Lee, Ling Hong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uy, Kim</au><au>Heang, Oy</au><au>Keo, Vanna</au><au>Kim, Yong June</au><au>Gollogly, Jim</au><au>Lee, Ling Hong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2022-01</date><risdate>2022</risdate><volume>46</volume><issue>1</issue><spage>54</spage><epage>60</epage><pages>54-60</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite-related musculoskeletal injuries at Children’s Surgical Centre, Phnom Penh, Cambodia.
Methods
We conducted a retrospective case series analysis of patients with snakebite-related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= < one year vs. > one year, respectively) based on their time interval from snake bite to time of presentation.
Results
There were 88 patients who presented with snakebite-related musculoskeletal injury during the cohort study period. Majority of them were male (
n
= 62, 71%) and had a median age of 24 years old (IQR 17–44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher’s test
p
= 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months–11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher’s test
p
< 0.0001). For management, surgical debridement was the most common primary intervention for the early group (52% vs. 19%), and contracture release was the most common for patients in the late group (62% vs. 15%) (Fisher’s test
p
= 0.0004). Overall, the postoperative complication rate was highest in the late presenting group (34% vs. 3%, Fisher’s test
p
= 0.005).
Conclusion
More than half of the patients presented with musculoskeletal injury require surgical correction. Our study demonstrated that scar contracture is the most common complaint among the late presenting group and is associated with high postoperative complication rate.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34523046</pmid><doi>10.1007/s00268-021-06307-w</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3313-035X</orcidid></addata></record> |
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| ispartof | World journal of surgery, 2022-01, Vol.46 (1), p.54-60 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adolescent Adult Cambodia - epidemiology Cardiac Surgery Child Cicatrix Cohort Studies Complications Female General Surgery Humans Injuries Injury analysis Male Medicine Medicine & Public Health Patients Postoperative Public health Rehabilitation Retrospective Studies Snake bites Snake Bites - complications Snake Bites - epidemiology Surgery Surgery in Low and Middle Income Countries Thoracic Surgery Vascular Surgery Venom Young Adult |
| title | Surgical Management of Patients with Snakebite-Related Musculoskeletal Complication–A Single Institution Experience in Cambodia |
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