Sandoval-Cuevas B, Mervitch-Sigal N, Paz-Michel B, Cabrera-Licona A

Language: Spanish
References: 22
Page: 20-28
PDF size: 349.39 Kb.

ABSTRACT

Cutaneous loxoscelism wounds can be complicated by concomitant infections because the diagnosis is presumptive and there is no specific treatment scheme. Neutral electrolyzed water (SES) has been shown to be effective in the treatment of severe skin lesions due to their antiseptic and tissue regeneration effects and could therefore be a healing method for skin loxoscelism lesions. We present the case of a 73-year-old male patient with heart disease, diagnosed with cutaneous loxoscelism in the left ankle, who received conventional treatment of antibiotics, anti-inflammatories, antihistaminics, and analgesics. He was discharged. However, the injury developed and was treated at home with traditional remedies. It extended 360° and presented a fetid exudate at the time he decided to return to the hospital. In the clinic it was decided to manage the lesion in the first instance with washes with SES and debridement, followed by washes with SES and SES gel dressings three times a day for 3 days, achieving control of the infection at that moment. Subsequently, with the regimen based on the application of SES every 48 hours, the appearance of granulation tissue was observed on day 7, and re-epithelialization on day 45 after starting the SES approach, the total closure of the lesion was achieved on day 67. The treatment scheme based on the use of neutral electrolyzed water proved to be effective in controlling the infection and in inducing the tissue-generation process that led to the closure of the wound without complications for the patient.

REFERENCES

1. Medina-Torres I, Guadarrama-Cruz LO, Soto-Serrano G,Reséndiz-Tinajero HH. Comportamiento de la Intoxicaciónpor veneno de arañas en el Estado de México. BoletínEpidemiológico. Sistema Nacional de Vigilancia Epidemiológica.Sistema Único de Información. 2016;33:24.

2. Aspectos generales y medidas de Prevención de la mordedurade la Araña violinista (Loxosceles). México: Secretaríade Salud; 2016. Disponible en: https://www.gob.mx/salud/documentos/aspectos-generales-y-medidas-de-prevencionde-la-mordedura-de-la-arana-violinista-loxosceles

3. Lopes PH, Squaiella-Baptistão CC, Marques MOT, TambourgiD V. Clinical aspects, diagnosis and management ofLoxosceles spider envenomation: literature and case review.Arch Toxicol. 2020;94(5):1461-77.

4. Sanabria Hernán, Zavaleta Alfonso. Panorama epidemiológicodel loxoscelismo en el Perú. Rev Med Exp. SaludPública. 1997;14:33-41.

5. Málaque CMSA, Castro-Valencia JE, Cardoso JLC, FrançaFO de S, Barbaro KC, Fan HW. Clinical and epidemiologicalfeatures of definitive and presumed loxoscelism inSão Paulo, Brazil. Rev Inst Med Trop Sao Paulo. 2002;44(3):139-43.

6. Ríos JC, Pérez M, Sánchez P, Bettini M, Mieres JJ, ParisE. Caracterización clínico-epidemiológica telefónica de lamordedura por araña de rincón, en un centro de informacióntoxicológica de Chile, durante el año 2005. Rev MedChil. 2007;135(9):1160-5.

7. Cabrerizo S, Docampo PC, Cari C, Rozas M, Díaz M, DeRoodt A, et al. Loxoscelismo: epidemiología y clínica deuna patología endémica en el país. Arch Argent Pediatr.2009;107(2):152-9.

8. Nguyen N, Pandey M. Loxoscelism: Cutaneous and HematologicManifestations. Adv Hematol. 2019;2019:4091278.

9. Rhoads J. Epidemiology of the brown recluse spider bite. JAm Acad Nurse Pract. 2007;19(2):79-85.

10. Jerusalem K, Salavert Lletí M. Probable cutaneous loxoscelismwith mild systemic symptoms: A case report fromSpain. Toxicon. 2018;156:7-12.

11. Rubenstein E, Stoebner PE, Herlin C, et al. Documentedcutaneous loxoscelism in the south of France: an unrecognizedcondition causing delay in diagnosis. Infection.2016;44(3):383-7.

12. Gremski LH, Trevisan-Silva D, Ferrer VP, et al. Recentadvances in the understanding of brown spider venoms:From the biology of spiders to the molecular mechanismsof toxins. Toxicon. 2014;83:91-120.

13. Guía de Evidencias y Recomendaciones: Guía de PrácticaClínica: Diagnóstico y Tratamiento de Mordedura porArañas Venenosas. GP: SSA-523-11. México: CENETEC;2015. Disponible en: http://www.cenetec-difusion.com/CMGPC/SS-523-11/RR.pdf

14. Tanaka H, Hirakata Y, Kaku M, et al. Antimicrobial activityof superoxidized water. J Hosp Infect. 1996;34(1):43-9.

15. Velazquez-Meza ME, Hernández-Salgado M, Sánchez-Alemán MA. Evaluation of the Antimicrobial Activity of aSuper Oxidized Solution in Clinical Isolates. Microb DrugResist. 2015;21(4):367-72.

16. Yahagi N, Kono M, Kitahara M, et al. Effect of ElectrolyzedWater on Wound Healing. Artif Organs. 2000;24(12):984-7.

17. Eftekharizadeh F, Dehnavieh R, Hekmat SN, MehrolhassaniMH. Health technology assessment on super oxidizedwater for treatment of chronic wounds. Med J Islam RepubIran. 2016;30(1):384.

18. Yan P, Daliri EB, Oh DH. New Clinical Applications ofElectrolyzed Water: A Review. Microorganisms. 2021;9(1):1-21.

19. Tata MD, Kwan KC, Abdul-Razak MR, ParamalingamS, Yeen WC. Adjunctive use of superoxidized solution inchest wall necrotizing soft tissue infection. Ann ThoracSurg. 2009;87(5):1613-4.

20. Montesinos-Peña NE, Hernández-Valencia M, Delgado-Enciso I, Herrera-Leal A, Paz-Michel BA. Evaluation of anantiseptic gel of intravaginal application for multitreatedpatients for infectious cervicovaginitis. Ginecol ObstetMex. 2019;87(07):454-66.

21. Paz-García J, Maldonado-Rodrígez A, Díaz-Reval I, MuñizJ, Rodríguez-Hernández A. Sustitución del uso de soluciónsalina fisiológica como irrigante en el manejo de pacientessépticos y quirúrgicos por solución electrolizada. Rev MexCirugía Bucal y Maxilofac. 2011;7(2):46-52.

22. Bryan N, Ahswin H, Smart N, Bayon Y, Wohlert S, HuntJA. Reactive oxygen species (ROS)–a family of fate decidingmolecules pivotal in constructive inflammation and woundhealing. Eur Cell Mater. 2012;24(249):e65.