{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:37:41Z","timestamp":1787063861504,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Pit viper snakebites are challenging as they often cause tissue injury and secondary bacterial infection that may impair full recovery of the affected limb. We describe the evolution of a snakebite injury with secondary infection and the use of specialized dressings to achieve tissue repair and complete closure of the wound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE:<\/jats:title>\n                    <jats:p>Ms E., a 45-year-old woman, was bitten by a pit viper that began as a small lesion and progressed to necrosis, cellulitis, edema, and hyperemia of the perilesional skin, local inflammation, and infection. We implemented a combination of topical hydrogel therapy with calcium alginate and hydrofiber with 1.2% silver to promote autolytic debridement, combat local infection, and provide a moist wound environment. The wound required daily local treatment for 2 months due to extensive tissue damage, combined with the proteolytic action of the bothropic venom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>The care of wounds caused by snakebites is a challenge for the health care team due to tissue loss resulting from the action of the venom and secondary bacterial infection. Close follow-up with the use of systemic antibiotics and topical therapies proved effective in minimizing tissue loss in this case.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/won.0000000000000963","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T14:02:03Z","timestamp":1683295323000},"page":"245-249","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Treatment of a Snakebite Injury With Secondary Bacterial Infection"],"prefix":"10.1097","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5723-9977","authenticated-orcid":false,"given":"Jacqueline de Almeida Gon\u00e7alves","family":"Sachett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samara Sousa Carvalho","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frandison Gean Souza","family":"Soares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Arthur","family":"Alc\u00e2ntara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna Beatriz de Souza","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana Marques Gomes","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iran Mendon\u00e7a","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuelton Marcelo","family":"Monteiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"suppl I","key":"R1-20250806","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1590\/0037-8682-0105-2013","article-title":"Snakebites as a largely neglected problem in the Brazilian Amazon: highlights of the epidemiological trends in the states of Amazonas","volume":"48","author":"Feitosa","year":"2015","journal-title":"Rev Soc Bras Med Trop"},{"issue":"12","key":"R2-20250806","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0208532","article-title":"Stepping into a dangerous quagmire: macroecological determinants of Bothrops envenomings, Brazilian Amazon","volume":"13","author":"Alc\u00e2ntara","year":"2018","journal-title":"PLoS One"},{"issue":"9","key":"R3-20250806","doi-asserted-by":"crossref","first-page":"e0009758","DOI":"10.1371\/journal.pntd.0009758","article-title":"Snakebites in \u201cinvisible populations\u201d: a cross-sectional survey in riverine populations in the remote Western Brazilian Amazon","volume":"15","author":"Maciel Salazar","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"R4-20250806","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/trstmh\/try121","article-title":"Snakebite envenomation in the Brazilian Amazon: a descriptive study","volume":"113","author":"Magalh\u00e3es","year":"2019","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"3","key":"R5-20250806","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3855\/jidc.39","article-title":"Wound infections secondary to snakebite","volume":"3","author":"Garg","year":"2009","journal-title":"J Infect Dev Ctries"},{"issue":"5","key":"R6-20250806","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/qjmed\/90.5.323","article-title":"Snake bites by the jararacu\u00e7u (Bothrops jararacussu): clinicopathological studies of 29 proven cases in S\u00e3o Paulo State, Brazil","volume":"90","author":"Milani J\u00fanior","year":"1997","journal-title":"QJM"},{"key":"R9-20250806","doi-asserted-by":"crossref","first-page":"e0244","DOI":"10.1590\/0037-8682-0244-2021","article-title":"Secondary infection profile after snakebite treated at a tertiary referral center in the Brazilian Amazon","volume":"55","author":"Mendes","year":"2022","journal-title":"Rev Soc Bras Med Trop"},{"issue":"6","key":"R10-20250806","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jmii.2011.04.011","article-title":"Bacterial infection in association with snakebite: a 10-year experience in a northern Taiwan medical center","volume":"44","author":"Chen","year":"2011","journal-title":"J Microbiol Immunol Infect"},{"issue":"1","key":"R11-20250806","first-page":"96","article-title":"Snake poisoning","volume":"23","author":"Castrill\u00f3n-estrada","year":"2007","journal-title":"Salud Uninorte"},{"issue":"9\/10","key":"R12-20250806","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S0300-9084(00)01163-9","article-title":"Snake venom metalloproteinases: their role in the pathogenesis of local tissue damage","volume":"82","author":"Gutierrez","year":"2000","journal-title":"Biochimie"},{"issue":"8","key":"R13-20250806","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1016\/j.toxicon.2010.08.011","article-title":"Comparative analysis of newborn and adult Bothrops jararaca snake venoms","volume":"56","author":"Antunes","year":"2010","journal-title":"Toxicon"},{"issue":"7","key":"R14-20250806","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0132237","article-title":"Older age and time to medical assistance are associated with severity and mortality of snakebites in the Brazilian Amazon: a case-control study","volume":"10","author":"Feitosa","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"R15-20250806","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1590\/S0104-42302001000100026","article-title":"Ofidismo","volume":"47","author":"Pinho","year":"2001","journal-title":"Rev Assoc Med Bras"},{"issue":"2","key":"R16-20250806","first-page":"172","article-title":"Tratamento Da Ferida Por Acidente Of\u00eddico: Caso Cl\u00ednico","volume":"10","author":"Schulz","year":"2016","journal-title":"Cuid Enferm"},{"issue":"7","key":"R17-20250806","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0005745","article-title":"Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: a randomized controlled clinical trial","volume":"11","author":"Sachett","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"R18-20250806","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1590\/S0036-46651990000100002","article-title":"Bacterial flora of the oral cavity, fangs and venom of Bothrops jararaca: possible source of infection at the local bite","volume":"32","author":"Jorge","year":"1990","journal-title":"Rev Inst Med Trop S\u00e3o Paulo"},{"issue":"2","key":"R19-20250806","first-page":"21","article-title":"Principais compostos qu\u00edmicos presente nos venenos de cobras dos g\u00eaneros Bothrops e Crotalus\u2014Uma Revis\u00e3o","volume":"2","author":"Cunha","year":"2012","journal-title":"Rev Eletr\u00f4nica Educ e Ci\u00eancia"},{"issue":"3","key":"R20-20250806","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1590\/0037-8682-0333-2015","article-title":"Hallux amputation after a freshwater stingray injury in the Brazilian Amazon","volume":"49","author":"Monteiro","year":"2016","journal-title":"Rev Soc Bras Med Trop"},{"issue":"2","key":"R21-20250806","first-page":"81","article-title":"Bilateral amputation of inferior extremities due to serious Bothrops accident: a case report","volume":"53","author":"Valle","year":"2008","journal-title":"Arq Med Hosp Fac Cienc Med St Casa S\u00e3o Paulo"},{"issue":"9","key":"R22-20250806","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.trstmh.2003.12.009","article-title":"Failure of chloramphenicol prophylaxis to reduce the frequency of abscess formation as a complication of envenoming by Bothrops snakes in Brazil: a double-blind randomized controlled trial","volume":"98","author":"Jorge","year":"2004","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"4","key":"R23-20250806","doi-asserted-by":"crossref","first-page":"73","DOI":"10.19178\/Sci.Amazon.v4i1.73-84","article-title":"Snake bites in northern Brazil and the use of plant species as an alternative and complementary treatment serotherapy","volume":"1","author":"Mour\u00e3o De Moura","year":"2015","journal-title":"Sci Amaz"},{"key":"R25-20250806","first-page":"93","article-title":"Cobertura cut\u00e2nea em pacientes v\u00edtimas de acidentes of\u00eddicos","volume":"27","author":"Galli","year":"2012","journal-title":"Rev Bras Cir Pl\u00e1st"},{"issue":"15","key":"R26-20250806","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1111\/j.1365-2702.2008.02381.x","article-title":"A systematic review of wound cleansing for pressure ulcers","volume":"17","author":"Moore","year":"2008","journal-title":"J Clin Nurs"},{"issue":"9","key":"R27-20250806","first-page":"133","article-title":"A efic\u00e1cia das solu\u00e7\u00f5es de limpeza para o tratamento de feridas: uma revis\u00e3o sistem\u00e1tica","volume":"IV","author":"Santos","year":"2016","journal-title":"Rev Enferm Ref"},{"issue":"4","key":"R28-20250806","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5327\/Z1806-3144201600040004","article-title":"Knowledge of nurses in the indication of coverage in care of wounded clients","volume":"14","author":"Prado","year":"2017","journal-title":"Estima"}],"container-title":["Journal of Wound, Ostomy &amp; Continence Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/WON.0000000000000963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:01:19Z","timestamp":1754492479000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/WON.0000000000000963"}},"subtitle":["A Case Study"],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/won.0000000000000963","relation":{},"ISSN":["1071-5754"],"issn-type":[{"value":"1071-5754","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}