Abstract：
There are numerous emergency department visits in the United States for all types of marine animal injuries each year. These injuries may result in significant morbidity or mortality if not managed appropriately. Accurate identification of the offending species, thorough wound hygiene, and judicious use of antibiotics are important for preventing infections. This review aims to describe management strategies and antimicrobial considerations for nonmammalian marine vertebrate penetrating trauma in North America, the Caribbean, and Hawaii. A literature search was performed to identify studies on this subject. This literature consisted of clinical case reports and case series. Reports extracted included those on sharks, barracuda, eels, catfish, stingrays, lionfish, stonefish, and scorpionfish. The majority of reported trauma occurred to beachgoers, fishermen, or commercial aquarium employees who routinely handle these animals. Injury patterns depended on the species but most commonly affected the lower extremities. Infections were seen from saltwater bacteria, human skin flora, or marine animal oral flora. After thorough wound irrigation and exploration, most authors recommended prophylactic antimicrobials to cover Vibrio species, in addition to other gram-negative and gram-positive species. The literature is notable for the lack of controlled studies. Some authors recommended radiographic and/or ultrasonographic imaging to identify retained foreign bodies, such as spines, sand, or teeth.
摘要：
在美国，每年都有许多针对所有类型的海洋动物伤害的急诊科就诊。如果管理不当,这些损伤可能导致显著的发病率或死亡率。准确识别违规物种，彻底的伤口卫生，合理使用抗生素对预防感染很重要。这篇综述旨在描述北美非哺乳动物海洋脊椎动物穿透性创伤的管理策略和抗菌考虑因素，加勒比海,和夏威夷。进行了文献检索以确定有关该主题的研究。该文献包括临床病例报告和病例系列。提取的报告包括关于鲨鱼的报告，梭鱼,鳗鱼,鲶鱼,黄貂,狮子鱼,石鱼,和蝎子。大多数报告的创伤发生在泳客身上，渔民,或常规处理这些动物的商业水族馆员工。损伤模式取决于物种，但最常见于下肢。感染来自盐水细菌，人类皮肤菌群，或海洋动物口腔菌群。经过彻底的伤口冲洗和探查，大多数作者推荐预防性抗微生物药物来覆盖弧菌物种，除了其他革兰氏阴性和革兰氏阳性物种。这些文献值得注意的是缺乏对照研究。一些作者推荐放射和/或超声成像来识别残留的异物，比如刺，沙子,或牙齿。
