Part 1 of 3
Hello,
My name is Jordan Benjamin, I am a herpetologist specializing in venomous snakes and a wilderness medicine practitioner with experience treating many snakebite patients in West and East Africa, most of them in remote health centers that pose some of the same challenges as treatment of a snakebite in the wilderness or backcountry environment in the US (supplies are limited or non-existent, the patient has a long way to go to reach a hospital, etc). I have also been fortunate to have the opportunity to train a number of individuals and groups in snakebite medicine and field management of snake envenomations in remote conditions including medical officers and corpsmen with the US military, local & international doctors and nurses in African hospitals, wildlife rangers, etc. I am including my background and real name because this issue is important to me and I stand by everything I am about to write; I want to give you all the peace of mind that I am who I say I am and not some competing company throwing out baseless accusations behind the cloak of online anonymity. Feel free to look me up online, I gave a TEDx talk on the issue of snakebite in sub-Saharan Africa last year and I invite those who doubt my identity or simply want to learn more about the issue of snakebite in the developing world to check it out. Moving on to the review...
The short answer to the question of whether or not the Sawyer Extractor can effectively remove venom from the site of the bite is a resounding no: the Sawyer Extractor and all of the other "snakebite kit" variations employing suction, incisions, electricity, heat, cold, and so forth have been repeatedly shown to be utterly ineffective at the job they are designed and marketed to accomplish. They simply do not work! The caveat it that there is one clever application of the sawyer that has been proven to work great, which is for the removal of flesh-eating botfly larvae that can be acquired in various tropical regions of the world...see "Simple and effective field extraction of human botfly, Dermatobia hominis, using a venom extractor" [...]. I am afraid to say that at the moment that is the only medical situation where this device may possibly prove helpful. When it comes to snakebites, it is not only completely ineffective at removing venom from tissue following a snakebite, but may actually prove harmful and cause a serious local necrosis (think in terms of a cookie-cutter style wound forming a deep cylinder of rotting dead tissue under the site of application). This may be due to a concentration of residual cytotoxic and myotoxic venoms near the site of the bite, while the majority of the venom will continue to diffuse into systemic circulation - but since we really don't know exactly why this happens that is purely speculation. For any interested parties, the article demonstrating this is titled: "Effects of a negative pressure venom extraction device (Extractor) on local tissue injury after artificial rattlesnake envenomation in a porcine model." I am attaching a link to the article here: [...] There are probably several reasons why this type of first aid does not work. One issue is that the recurved fangs of vipers penetrate and inject venom deeply into the tissues beneath the skin, and the tunnel created when a fang penetrates the skin immediately collapses as soon as the fang is withdrawn. Another issue is that large quantities of venom are believed to diffuse very rapidly into different tissue compartments. This means that there is no direct route between the visible puncture marks on the surface to the area where venom was injected, and the significant quantity of venom is already well on its way. I have read the company's testimonials and seen the occasional news stories about a snakebite victim "whose life was saved by the Sawyer Extractor" or similar device, and all too often that is a quote attributed to the physician who treated them. I don't doubt the veracity of the quote as deeply entrenched myths and misinformation about snakes and snakebite are unfortunately as common in doctors as they are in the rest of society at this time. The sawyer extractor is popular because it provides us with an intuitively sound solution to the terrifying prospect of suffering a snakebite far from medical care, suddenly rendered utterly helpless as the venom takes effect and all we (or our loved ones) can do is wait and watch as the venom takes over. It is nothing more than a modern variation of the infamous "black stone" from Asia and Africa, a charred piece of cow bone that is stuck to the site of the snakebite and remains there absorbing fluid until all the venom has been drawn out of the bite whereupon it suddenly detaches and falls to the ground, is boiled or washed in milk to cleanse it of the venom, and ready to go when the next snakebite happens. Both of them provide the perfect optical illusion by visibly extracting some quantity of blood and straw-colored fluid (which looks incredibly similar to many viper venoms) from the site of the bite, but this is nothing more than the pale-yellow plasma (whats left after you remove the red cells and clotting components from blood) and other exudate draining from the wound as edema sets in and the venom begins to show effect. If you feel like you have been duped, don't take it personally - the notion that a snakebite can be treated by somehow extracting the venom has successfully fooled us since at least the 1400's, when the black stone was first mentioned as the go-to remedy for treating snake envenomations. Several years ago, a close colleague of mine met a European surgeon who was in Central Africa on a medical mission and explained that he needn't worry about snakebite, because he always carried a black stone with him for such a situation...as you can see, even the most highly educated medical professionals are not immune to the myths that pervade the issue of snakebite. I grew up carrying a sawyer extractor with me whenever I went out to look for snakes and lizards, and no one would be happier to hear that the sawyer extractor did what it claims than those of us who work with snakes and face an incidence of snakebite many times higher than that of the larger population. But the reality is that these devices do not work for snakebites, and marketing them for that purpose is a dangerous action with potentially tragic consequences. Evidence-based medicine and all studies to date suggest that they are at best ineffective and at worst harmful. If you would like to see more evidence of this, check out:
"Snakebite Suction Devices Don’t Remove Venom: They Just Suck" [...] and
Suction for Venomous Snakebite: A Study of 'Mock Venom' Extraction in a Human Model" [...].