Treatment of poisonous snakebite with emphasis on digit dermotomy.

Despite the remarkably low mortality from poisonous snakebites in the United States during the past few years, there has been little improvement in preventing deformities of digits. Using a retrospective study of 207 cases of poisonous snakebite, I present a method that has been highly successful in avoiding deformities, especially in the fingers. This simple procedure requires no general anesthetic and can be done in the emergency department. No secondary surgical closure is required. Included are recommendations for first aid treatment in the field and an outline for evaluation and treatment in the emergency department. Cooling should never be used and fasciotomies are almost never necessary.