Manajemen Terpadu Sengatan Ikan Pari: Dari Penanganan Prarumah Sakit hingga Perawatan Intensif

Abstract

Stingray envenomation is a form of aquatic injury resulting from a combination of mechanical trauma caused by barb penetration and venom inoculation into the tissue. This injury may produce clinical manifestations ranging from localized pain, edema, and tissue necrosis to infection, neurovascular injury, rhabdomyolysis, sepsis, and organ dysfunction requiring intensive care. This article aims to review current evidence regarding the clinical manifestations and integrated management of patients with stingray envenomation. A narrative literature review was conducted using international open-access articles published between 2021 and 2026 that addressed epidemiology, mechanisms of injury, clinical manifestations, prehospital management, emergency department care, antimicrobial therapy, complications, and intensive care. The review findings indicate that most injuries involve the lower extremities and generally have a favorable prognosis when appropriate initial management is provided. Hot-water immersion is effective as an initial approach for pain relief, accompanied by wound irrigation, exploration, foreign-body assessment, and debridement when indicated. Routine antibiotic prophylaxis is not required for all patients but may be considered for high-risk wounds. Severe injuries may require advanced imaging, surgical intervention, and intensive care. These findings emphasize the need for an integrated, severity-based approach to reduce morbidity and prevent serious complications.