title: A Multidisciplinary Approach with Hyperbaric Oxygen Therapy Improve Outcome in Snake Bite Injuries.
abstract: OBJECTIVE
  Snakebite injuries are common in tropical India among those who are involved in outdoor activities. These injuries results in cellulitis, gangrene at the bite area, bleeding manifestations, compartment syndrome, regional lymphadenopathy, septicemia, hypotension, and disseminated intravascular coagulation (DIC) resulting in significant morbidity and mortality. The purpose of this study is to share our experience of multidisciplinary approach in the management of snakebite injuries of the extremities with various treatment modalities including hyperbaric oxygen (HBO) therapy, surgical debridement, and soft tissue reconstruction to provide an effective treatment for snake bite injuries.
  
  
  METHODS
  The study was conducted in the Department of Plastic Surgery, during the period October 2012-December 2014, wherein all the patients who were admitted with snakebite injuries were enrolled and the patients treated in plastic surgery department were included into the study. Out of total 766 patients, there were 323 patients treated with anti snake venom (ASV) and 29 died among the treated patients; 205 patients belonged to pediatric age group.
  
  
  RESULTS
  Out of 112 patients referred to Department of Plastic Surgery, 50 cases presented with cellulitis, 24 patients with compartment syndrome, and 38 patients were referred for the management of soft tissue cover over the extremities. Among 112 patients, 77 involved the lower extremity and 35 the upper extremity.
  
  
  CONCLUSIONS
  Multidisciplinary approach including hyperbaric oxygen (HBO) therapy improves outcome in the management of snakebite injuries of the extremities.
authors: Department of Plastic Surgery and Burns, Jubilee Institute of Surgery for Hand, Aesthetic and Microsurgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
authors: Pradeoth Mukundan
authors: PM
authors: Korambayil
authors: Department of Plastic Surgery and Burns, Jubilee Institute of Surgery for Hand, Aesthetic and Microsurgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
authors: Prashanth Varkey
authors: PV
authors: Ambookan
authors: Department of Emergency Medicine, Jubilee Institute of Surgery for Hand, Aesthetic and Microsurgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
authors: Siju Varghese
authors: SV
authors: Abraham
authors: Department of Emergency Medicine, Jubilee Institute of Surgery for Hand, Aesthetic and Microsurgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
authors: Ajay
authors: A
authors: Ambalakat
keywords: Hyperbaric oxygen therapy; snakebite injury; soft tissue reconstruction; upper and lower extremity