Table 4: Description of the interventions of

each study chosen with the results and outcomes obtained.

Study

Population (n)

Intervention

Outcomes

Auer

Arthur I17

33

• Early incision: <10 days + second-time closure with suture or grafting

• Late incision: 3-10 weeks + closure

• Late incision: 3-11 weeks + grafting

Cure, in most cases,

1 infection,

1 graft slippage

with partial loss

Cure in most cases,

1 late infection

4 graft losses,

2 unsuccessful closures,

1 phlebitis

Rees

Riley S18

31

• Early surgical excision < 48 hours

• Dapsone + late surgical excision

6 cases of late healing,

3 infections,

1 ulnar nerve entrapment

3 complete cures,

4 resolutions in 2 weeks,

2 in 3 weeks,

1 infection,

2 cellulitis.

3 nodulation

Staneff

John19

7

Decompressive fasciotomies, necrosectomy, flap or grafting

Clinical recovery of patients in an average of 11 days

Maguiña

Ciro20

39

• Dapsone 100 mg

• Chlorphenamine 4 mg

Favorable outcome in 18 of 20 patients

Favorable outcome in 10 of 19 patients

Maguiña

Ciro21

39

• Dapsone 100 mg

• Chlorphenamine 4 mg

Infected ulcers treated with clindamycin 300 mg

Rees

Riley S.22

16

• Dapsone 250 mg

• Anti-loxosceles serum 2 mg/mL

• Dapsone + Anti-loxosceles serum

Healed in 20 ± 2 days,

2 cutaneous necroses in large ulcers

Borrasca-

Fernandes

Carla23

8

Anti-loxosceles serum 46 hours post-bite

Complete healing between 34 and 98 days in 6 patients

Malaque

Ceila MS24

146

• 74 cases with anti-loxosceles serum

• 72 cases without anti-loxosceles serum

Lower probability of developing necrosis

Seven early adverse reactions, 4 early adverse reactions, 3 local infection

Isbister

Geoffrey K25

75

Anti-loxosceles serum

Complete response in 97%. 2 early allergic reactions and 1 case of serum sickness

Manriquez

Juan J26

–

Dapsone, surgical treatment, chlorphenamine, anti-loxosceles serum

–

Hobbs

Gregory D27

32

• Hyperbaric Oxygen At 2 atm for 2 hours

• Dapsone 50 mg

• HOB + dapsone

Reduction of induration at days 7 and 14 in treatment with dapsone

Phillips

Scott28

–

• Hyperbaric oxygen at 2.5 atmospheres

• Dapsone 1.1 mg/kg

• Cyproheptadine 0.125 mg/kg

Decrease in the total size of the lesion

Maynor

M. L29

41

• Without hyperbaric oxygen

• Hyperbaric oxygen at 2.5 atmospheres with O2 100%

• Normoxic hyperbaric oxygen

Significant reduction in wound size at 10 days with 2.5 atmospheres with O2 100%.

Hadanny

Amir30

3

Hyperbaric oxygen

2-3 months later

Full resolution

Del Puerto

Constanta31

17

Intravenous antibiotics, systemic corticosteroids, dapsone, dapsone, etc.

Complete resolution in 50% with corticosteroids and dapsone

Complete resolution in 3 patients on steroids

Mold

James W32

262

Corticosteroids, dapsone, topical nitroglycerin, and vitamin C

Slower healing with corticosteroids and dapsone

Increased probability of healing with dapsone

Schenone

H33

216

Antihistamines, injectable corticosteroids, anti-loxosceles serum

Local control at 12 noon

Wong S.

Lindsey34

8

Negative pressure

(vacuum-assisted closure)

Healing of all wounds

Chrysostomou

D35

11

Topical nanocrystalline silver

8 complete healings in one week, 3 wounds sloughed