Necrotizing Skin Infections, Snakebite Envenomation
Conditions
Keywords
Snakebite, Necrotizing Infection, Risk Factors, Predictive Modeling, Venomous Snakes, D-dimer, Snakebite Severity Score, Blood Glucose Levels
Brief summary
This multicenter retrospective study aims to identify the risk factors associated with necrotizing skin infections following venomous snakebites and to develop a predictive model. Clinical data from 99 patients treated between January 2020 and April 2024 at three hospitals in Guangdong Province, China, were analyzed.
Detailed description
Venomous snakebites are a significant public health issue, particularly in tropical and subtropical regions like southern China. Necrotizing skin infections are a severe but relatively rare complication of venomous snakebites, often resulting from delayed treatment and bacterial invasion. This study retrospectively analyzed clinical data from 99 patients with venomous snakebites treated at three hospitals in Guangdong Province between January 2020 and April 2024. The primary objective was to identify the major risk factors associated with the development of necrotizing skin infections and to build a predictive model to assist in clinical decision-making. The study included male and female patients aged 14 years and older. Patients with incomplete medical records, long-term use of immunosuppressants, or underlying immunodeficiency diseases were excluded. Multivariate logistic regression identified the Snakebite Severity Score (SSS), blood glucose levels, and D-dimer levels as significant independent predictors of necrotizing infections.
Interventions
DRUGAntivenom Serum
Intravenous administration of 6000 IU of antivenom serum was given to patients envenomed by pit vipers. This treatment was based on Chinese guidelines for the management of snakebites. Additionally, patients received supportive treatments, including antibiotics to prevent infection, antihistamines for allergic reactions, and magnesium sulfate for localized swelling and pain relief.
PROCEDUREWound Debridement
Patients who did not develop necrotizing skin infections received wound management, including multiple punctures using a three-edged needle for toxin drainage, along with standard wound care and debridement as necessary to prevent infection and promote healing.
Sponsors
Central People's Hospital of Zhanjiang
Affiliated Hospital of Guangdong Medical University
Guangzhou Institute of Respiratory Disease
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Diagnosis of venomous snake bites confirmed according to major international clinical guidelines and expert consensus. * Availability of complete case data. * Provision of written informed consent by the patients or their legal guardians.
Exclusion criteria
* Age less than 14 years. * Long-term use of immunosuppressants or corticosteroids. * Presence of concurrent immunodeficiency diseases (e.g., HIV positive). * Severe malnutrition. * Incomplete medical records.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Necrotizing Skin Infections | 30 days from admission or until discharge. | The primary outcome measure is the incidence of necrotizing skin infections among venomous snakebite patients within the study period. Necrotizing infections were identified based on clinical diagnostic criteria, including tissue necrosis, infection severity, and systemic symptoms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital Length of Stay | From hospital admission until discharge, typically ranging between 1 and 30 days. | The secondary outcome measure is the duration of hospitalization for patients with venomous snakebites, comparing those who developed necrotizing skin infections with those who did not. |
Countries
China
Outcome results
None listed