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Prospecting Local Treatments Used in Conjunction with Antivenom Administration Following Envenomation Caused by Animals: A Systematic Review.
Carvalho ÉS
,
Oliveira I
,
Nascimento TP
,
da Silva Neto AV
,
Leal BAS
,
Araújo FQ
,
Julião BFV
,
Souza ARN
,
Abrahim AW
,
Macedo BBO
,
de Oliveira JTS
,
Wen FH
,
Pucca MB
,
Monteiro WM
,
Sachett JAG
.
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Envenomation caused by venomous animals may trigger significant local complications such as pain, edema, localized hemorrhage, and tissue necrosis, in addition to complications such as dermonecrosis, myonecrosis, and even amputations. This systematic review aims to evaluate scientific evidence on therapies used to target local effects caused by envenomation. The PubMed, MEDLINE, and LILACS databases were used to perform a literature search on the topic. The review was based on studies that cited procedures performed on local injuries following envenomation with the aim of being an adjuvant therapeutic strategy. The literature regarding local treatments used following envenomation reports the use of several alternative methods and/or therapies. The venomous animals found in the search were snakes (82.05%), insects (2.56%), spiders (2.56%), scorpions (2.56%), and others (jellyfish, centipede, sea urchin-10.26%). In regard to the treatments, the use of tourniquets, corticosteroids, antihistamines, and cryotherapy is questionable, as well as the use of plants and oils. Low-intensity lasers stand out as a possible therapeutic tool for these injuries. Local complications can progress to serious conditions and may result in physical disabilities and sequelae. This study compiled information on adjuvant therapeutic measures and underscores the importance of more robust scientific evidence for recommendations that act on local effects together with the antivenom.
Figure 1. Studies focusing on local therapies following envenomation. (A) Distribution of the venomous animals that caused the envenomation. (B) Year of publication of the selected studies. Regarding the publication period are addressed in the periods in which these articles were published. An increase in scientific output is observed in the years 2009, 2014, and 2016. (C) Number of studies by country. All countries cited in the publications were evaluated by the number of studies, with Brazil and USA producing the most. (D) Distribution of study types. In respect to the study type, the following results were obtained: (i) Pre-Clinical Study 71.79%; (ii) Clinical Trials: 12.82%; (iii) Case Reports: 5.13%; Randomized Clinical Trials: 5.13%; and (iv) Prospective Studies: 5.13%.
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