Reconstruction of a massive defect of the neck after a scorpion sting: A case report

Abstract

Introduction: Cutaneous traumas from scorpion sting envenomation are rare in European countries. Regarding Greece, Euscorpius sicanus' complex is the most widespread scorpion species. The venom of these small dark brown arthropods, which shelter in woods, usually provokes local cutaneous symptoms: erythema, edema, cellulitis, urticarial plaques, ulcers and rarely skin necrosis. We present a case of a massive soft tissue defect of the neck due to a scorpion sting managed by a Plastic Surgery Department in Greece. Case report: In March 2020, a 60 year-old lumberjack was referred to our Clinic due to a neck wound resulting from Euscorpius cf. sicanus sting. After multiple surgical debridements in combination with negative pressure wound therapy healthy tissue was achieved. Reconstruction followed using a 7cmX15cm vertical island trapezius musculocutaneous flap based on the dorsal scapular artery and rotated to cover the defect. The trapezius flap, donor site and graft healed well and resulted in satisfying contouring at the one–year follow–up. Conclusion: This case report is the first presenting Plastic Surgery reconstructive techniques for a massive neck defect after a Euscorpius cf. sicanus scorpion sting. Major complications of such stings need to be managed drastically for the optimum patient's outcome.

Keywords

• Euscorpius
• Scorpion
• Sting
• Neck defect
• Reconstruction
• Trapezius flap