arantzain (arantzain) wrote in little_details,

Thank you; Fasciotomy and Physical Therapy after Snakebite

First, just wanted to thank everyone who made suggestions to my last post, regarding my mystery photograph. We still haven't identified the model or photographer, but I have a lot more places to look!

Onto the business.

Setting: Louisiana, USA* - c. 1984
Scenario: While spending her summer vacation with family, a healthy nine year-old girl goes out on foot into the bayou/scrub* around her family's home. She sets out after dinner; several hours later she's missed. A search is organized.

At some point before she's found, she blunders into a canebrake rattlesnake (c. horridus) and is bitten on her ankle or lower leg.

Question 1 - Survival: I'm looking for a life-threatening bite, with necrosis and hemorrhage (so venom type A+B, for canebrakes)--something to leave very ugly scars that will last into adulthood. I'm not looking to kill the character, though: medical help can be as close as necessary, stopping just short of miraculous. Unfortunately, CroFab (the leading antivenom for rattler bites) will not be available until 2001, and I'm not sure how much this complicates her recovery.

Could a nine year-old girl survive an envenomed bite by a canebrake for a couple of hours? When the bite is on an extremity? She is not atypically allergic to the venom.

Question 2 - Treatment: My reading suggests that fasciotomies are a common solution to the violent swelling of tissue that results from a snakebite. (Please be careful googling/wiki'ing this if you have a weak stomach.)

Could this procedure have been performed in 1984? If so, how developed was skin-grafting technology? I see that the technique was developed in 1917; I just can't tell where the procedure was at in 1984.

Question 3 - Prognosis: Post-bite and fasciotomy, she'll have serious muscle damage; I'm wondering about walking and scarring. Looking at fasciotomy scars, it looks as though she'll have a long suture scar above the site and then a large oval patch of skin where the graft was performed--is that right? Will this scar have a distinctive texture, or will it just appear to be normal scar tissue? Will it stretch with her as she grows?

I assume she will be able to walk again unaided, in time, but will the bite and accompanying scars have any long-term effect on her ability to walk? Will she need a cane for long distances or stairs?

Googled: combinations of canebrake rattler; c. horridus; venom; bite; image; fasciotomy; prognosis; recovery; physical therapy. These searches turned up a number of awesome/awful personal anecdotes (with images!) and an article via Science Direct that discussed the limitations of CroFab for younger patients (proved to be irrelevant anyway) but I had a hard time interpreting the medicalese.

I have asked a similar question in the past, regarding a different species of snake; I did review that post as well, looking for some of these answers. Unfortunately the venom involved is very different.

Thank you all in advance for any help!
Tags: 1980-1989, usa: louisiana, ~medicine: injuries (misc), ~medicine: poisoning

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