産業医学および健康問題

抽象的な

Camel Bites  - A Unique Experience

Dheeraj Sharma, Sanjeev Devgarha and Rajendra Mohan Mathur

Introduction: Camel bites injuries are occupational and seasonal hazards which can cause serious limb, neck and chest injuries, potentially threatening the vascularity of the limbs with skin and soft tissue injuries. Proper health education of the people involved in handling camels and precautions and protective mask to camel's mouth during late winter and early summer can avoid these injuries. Proper referral, urgent revascularization can restore the vascularity of limb and prevent limb loss. Material and methods: We from the Department of CTVS, Sawai Mansingh Medical College and Hospitals, Jaipur, Rajasthan, India carried out a study of all the camel bite cases those presented to us or were referred to us for vascular and thoracic injuries, the factors that were responsible for the bite, its treatment and consequences were fully analyzed and studied. Observations: Between August 2008 to December 2013, 31 cases of Camel bite were encountered, out of which 23 cases were arterial injuries and 6 were thoracic wall bites and 2 were neck injuries. All were caused by domesticated camels, involved dominant side upper limbs/neck in 17 out of 23 arterial injury cases, dominant side of chest wall in 4 out of 6 thoracic wall bites, all bites were unprovoked, occurred during work or feeding, seasonally most occurred between december to march (during late winter and early summer) which can be co-related to mating season of camels. Results: 100% limb salvage was achieved with end to end repair in 13 cases and reverse saphenous vein interposition graft in 10 cases, with trunk flap in 2 and latissimus dorsi flap in 1 to give soft tissue cover. One case of Right axillary artery injury was encountered which was treated with subclavian to brachial bypass. 4 thoracic wall bites had hemothorax which were treated with intercostal tube drainage.