Prospecting Local Treatments Used in Conjunction with Antivenom Administration Following Envenomation Caused by Animals: A Systematic Review

Toxins (Basel). 2023 Apr 28;15(5):313. doi: 10.3390/toxins15050313.

Abstract

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.

Keywords: envenoming; local effects; local therapies; venomous animals.

Publication types

  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antivenins / therapeutic use
  • Insecta
  • Scorpions
  • Snake Bites* / drug therapy
  • Snakes
  • Spiders*

Substances

  • Antivenins

Grants and funding

This work was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, São Paulo Research Foundation scholarship to ISO No. 2020/13176-3 and No. 2022/08964-8), and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, The National Council for Scientific and Technological Development (scholarships to JAGS No. 311434/2021-5, MP No. 307184/2020-0, WM No. 309207/2020-7)). WM acknowledges funding support from Fundação de Amparo à Pesquisa do Estado do Amazonas (PAPAC 005/2019, PRO-ESTADO and POSGRAD calls). JAGS acknowledges funding support from Fundação de Amparo à Pesquisa do Estado do Amazonas (010/2021-CT&I Áreas Prioritárias and 011/2021-PCGP calls).