Lentz Ashley K, Burgess George H, Perrin Karen, Brown Jennifer A, Mozingo David W, Lottenberg Lawrence
Division of Plastic and Reconstructive Surgery, Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida 32610-0286, USA.
Am Surg. 2010 Jan;76(1):101-6.
Humans share a fascination and fear of sharks. We predict that most shark attacks are nonfatal but require skilled, timely medical intervention. The development of a shark bite severity scoring scale will assist communication and understanding of such an injury. We retrospectively reviewed records of the prospectively maintained International Shark Attack File (ISAF) at the University of Florida. The ISAF contains 4409 investigations, including 2979 documented attacks, 96 of which have complete medical records. We developed a Shark-Induced Trauma (SIT) Scale and calculated the level of injury for each attack. Medical records were reviewed for the 96 documented shark attack victims since 1921. Calculated levels of injury in the SIT Scale reveal 40 Level 1 injuries (41.7%), 16 Level 2 injuries (16.7%), 18 Level 3 injuries (18.8%), 14 Level 4 injuries (14.6%), and eight Level 5 injuries (8.3%). The overall mortality of shark attacks was 8.3 per cent. However, SIT Scale Level 1 injuries comprised the greatest percentage of cases at 41.7 per cent. Injury to major vascular structures increases mortality and necessitates immediate medical attention and definitive care by a surgeon. Shark bites deserve recognition with prompt resuscitation, washout, débridement, and follow up for prevention of infection and closure of more complex wounds.
人类对鲨鱼既着迷又恐惧。我们预测，大多数鲨鱼袭击事件不会致命，但需要专业、及时的医疗干预。制定鲨鱼咬伤严重程度评分量表将有助于对此类损伤的沟通与理解。我们回顾性地查阅了佛罗里达大学前瞻性维护的国际鲨鱼袭击档案（ISAF）的记录。ISAF包含4409项调查，其中包括2979起有记录的袭击事件，其中96起有完整的医疗记录。我们制定了鲨鱼致伤创伤（SIT）量表，并计算了每次袭击的损伤程度。对自1921年以来96名有记录的鲨鱼袭击受害者的医疗记录进行了审查。SIT量表计算出的损伤程度显示，1级损伤40例（41.7%），2级损伤16例（16.7%），3级损伤18例（18.8%），4级损伤14例（14.6%），5级损伤8例（8.3%）。鲨鱼袭击的总体死亡率为8.3%。然而，1级损伤在病例中占比最大，为41.7%。主要血管结构受损会增加死亡率，需要立即就医并由外科医生进行确定性治疗。对于鲨鱼咬伤，应立即进行复苏、冲洗、清创，并进行后续治疗，以预防感染和闭合更复杂的伤口。
