Hollabaugh R S, Fernandes E T
Department of Pediatric Surgery, LeBonheur Children's Hospital, Memphis, TN 38103.
J Pediatr Surg. 1989 Jan;24(1):126-7. doi: 10.1016/s0022-3468(89)80316-1.
The objectives in the treatment of the brown recluse spider bite are to prevent skin necrosis and the need for reconstructive surgery. A simple technique that consists of curetting the subcutaneous tissue in the necrotic area of the lesion, to prevent the local destructive actions of the toxin, is described. From 1981 to 1987, 18 patients were treated with this technique. The wounds were generally curetted under local anesthesia in an outpatient setting. In all but one case, the erythema, edema, and pain resolved significantly in 24 to 48 hours, and the wounds healed primarily with minimal scarring. We consider curettage the treatment of choice for brown recluse spider bites when the lesions are noted in relatively early stages. It can be performed as an outpatient procedure; it controls the symptoms and prevents further necrosis, with excellent cosmetic results.
治疗褐皮隐居蜘蛛咬伤的目标是防止皮肤坏死以及避免进行重建手术。本文描述了一种简单的技术，即刮除病变坏死区域的皮下组织，以防止毒素的局部破坏作用。1981年至1987年期间，18例患者接受了该技术治疗。伤口一般在门诊局部麻醉下进行刮除。除1例外，所有病例的红斑、水肿和疼痛在24至48小时内显著消退，伤口一期愈合，瘢痕极小。我们认为，当在相对早期发现病变时，刮除术是治疗褐皮隐居蜘蛛咬伤的首选方法。它可以作为门诊手术进行；能控制症状并防止进一步坏死，美容效果极佳。
