title: Snakebite in Korea: A Guideline to Primary Surgical Management.
abstract: OBJECTIVE
  Snakebite is an emergency which causes local symptoms such as pain and edema around the bite. Systemic symptoms may also develop, such as dizziness or renal failure, and may even cause death. The purpose of this research was to assess the validity and safety of snakebite protocol for surgery when treating snakebite patients.
  
  
  METHODS
  Retrospective research was performed on patients who were admitted after being treated at the emergency center from January 2008 to December 2012. When necessary, debridement was also performed, and 46 of 111 patients (41.4%) underwent debridement. Those who had received debridement without antivenom administration due to a positive skin reaction test were classified as group A, and group B received antivenom and delayed debridement. We reviewed the emergency and admission charts of the patients in each group and recorded and compared their age, sex, bite site, severity of local and general symptoms, time to receive antivenin, and complications.
  
  
  RESULTS
  Of the ten patients (21.7%) in group A, two (66.6%) developed cellulites, and one of them experienced skin necrosis, resulting in a skin graft. In group B, there were 36 patients (78.2%), 19 (52.7%) of whom developed cellulitis. Skin necrosis occurred in two patients, and one of these patients received a skin graft. Compartment syndrome was found in one patient, and fasciotomy and a skin graft were performed.
  
  
  CONCLUSIONS
  The treatment protocol implemented to treat snakebite patients admitted to the emergency center during this research was safely and properly followed during surgical treatment.
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea. nakjh78@naver.com.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Rha
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Kwon
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jin Rok
authors.initials: JR
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Byung Keun
authors.initials: BK
authors.lastname: Han
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kang Hyung
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000997:Antivenins / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003161:Compartment Syndromes; D003646:Debridement / Q000379:methods*; D019468:Disease Management; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D017410:Practice Guidelines as Topic; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation / Q000379:methods*; D012909:Snake Bites / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D012910:Snake Venoms / Q000009:adverse effects; D017695:Soft Tissue Injuries / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000997:Antivenins; D012910:Snake Venoms
keywords: Snakebite; antivenom; severity; surgical management