Resumo

VERMAAK, SS; VISSER, A  e  LE ROUX, TLB. A deadly bed partner: m'Fesi (Mozambique spitting cobra). SA orthop. j. [online]. 2010, vol.9, n.4, pp.58-62. ISSN 2309-8309.

Venomous snake bites are estimated to occur in 2.5 million people annually worldwide, with 125 000 resulting in death. The incidence of snake bites in Africa has been estimated at 100-400 bites per 100 000 people. Currently literature is largely restricted to case reports. In this case series, we describe three patients who sustained Mozambique spitting cobra bites on their hands, with their subsequent management. As was reported in the previous publications, all of the patients sustained snake bites while at home sleeping and two of the patients sustained multiple bites. All patients were bitten on their hands and developed significant soft tissue necrosis requiring surgical intervention. As reported in international publications, an initial delay in debridement led to improved outcome. Initial soft tissue necrosis has been shown to correlate poorly with ultimate wound demarcation. In accordance with publications, compartment syndrome did not occur in any of the patients, and swelling could be easily managed with simple elevation. In conclusion, m'Fesi bites are medical emergencies, but they warrant delayed wound debridement. Orthopaedic surgeons are often consulted for management of limb injuries; therefore, a thorough knowledge regarding management of cytotoxic snake bites should be a part of the general orthopaedic surgeon's training.

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