This territory is part of a transition area from the Cerrado to the Amazon, with a tropical climate, with an average annual temperature of 26.7 ☌.
The study was carried out in Palmas, Tocantins State, which has a territorial area of 2,218,942 km² and had a population of 306,296 inhabitants in 2019 12. Given the need for scientific evidence on the treatment approaches used, this study aimed to identify the therapies applied to stingray sting trauma from 2018 to 2019 and characterize patients' clinical and sociodemographic profiles. This reflects the poor preparation of health professionals in managing these patients. Some literature reports have shown antibothropic serum being administered for pain and inflammation and the use of ice compress however, these procedures are not indicated because of their low effectiveness 6, and the use of hot compresses in these cases is ideal 5, 6, 9.
#RF ONLINE SKIN PALMAS SET PROFESSIONAL#
In addition, many health professionals do not receive adequate training while graduating or during their professional activity 9.
Sting damage is aggravated because there is still no specific treatment for this category of accident. The average patient recovery time and ulcer healing take about three months however, severe poisonings that are not adequately treated can result in amputation or death 6, 7. Systemic symptoms such as tachycardia, fever, cold sweating, nausea, vomiting, and agitation have also been described and are usually associated with the victim's pain and stress 7, 8.
The wound is often disproportionately painful in relation to the visible clinical lesion 8, being persistent even with the use of anesthetics, analgesics, and anti-inflammatories 6. Pain is the main reported symptom, appearing with great intensity immediately after the sting, followed by local edema and erythema, evolving to cutaneous necrosis of variable degree 5, 9. In this way, when threatened, stingrays use their tail as a whip 5, 8, 10, causing a severe injury by mechanical action, which can traumatize the main nerves and blood vessels, and by chemical, through the release of toxins in the wound 6, 8, 10, 11. This mucus contains substances, such as peptides, which induce inflammation and vasoconstriction and, combined with the venom, increase the severity of injuries caused by the animal 5, 10. In addition, stingrays, like other fish, are covered in mucus that harbors various bacteria types that can cause secondary bacterial infections 6, 11. Stingrays of the Potamotrygonidae family are known for their long-tailed appendage, with one to four serrated calcified stingers covered by a glandular epithelium whose cells produce venom 10. Thus, bathers have accidents after stepping on stingrays, as they are hit, predominantly, in the lower limbs such as ankles and feet, while fishers, both professional and sports, are usually hit in the upper limbs, especially the hands when trying to manipulate them 9. These animals usually remain motionless, hidden by sand or mud at the bottom of rivers, with their eyes located dorsally, watching for the possibility of food and hiding from their predators 8. Due to the dry season, there is a decrease in river water levels and consequent exposure of beaches, which attract tourists, where accidents with stingrays are common 6, 7. The Tocantins-Araguaia basin is frequently used for recreational activities, especially between June and August. The Paratrygon aiereba species is the most common in the Tocantins-Araguaia basin, with the largest geographic distributions among the species of the genus 6. Confined to continental waters, stingrays have a wide distribution in South America, and about 20 species colonize all regions of Brazil 3, 4, 5. Among these animals are the freshwater stingrays of the Potamotrygonidae family, distributed in four genera: Potamotrygon, Paratrygon, Plesiotrygon, and Heliotrygon 2.
Brazil has the most extensive river network globally, whith many venomous animals 1.
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