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Original Article Plastic and Aesthetic Research

Hyperbaric oxygen therapy improves

outcome of snake envenomation: tertiary

center experience

Pradeoth Korambayil Mukundan , Prashanth Varkey Ambookan , Ragu Angappan 2
1
1
1 Department of Plastic Surgery, Jubilee Institute for Surgery of Hand, Aesthetic and Microsurgery, Thrissur 680005, Kerala, India.
2 Department of Plastic Surgery, Sushruta Cosmetic and Laser Surgery Centre, Coimbatore 641004, Tamil Nadu, India.
Address for correspondence: Dr. Pradeoth Korambayil Mukundan, Department of Plastic Surgery, Jubilee Institute for Surgery of Hand,
Aesthetic and Microsurgery, Bishop Alapatt Road, East Fort, Thrissur 680005, Kerala, India. E-mail: pradeoth@gmail.com

Dr. Pradeoth Korambayil Mukundan is a Consultant Plastic Surgeon in the Department of Plastic Surgery and Burns,
Bahrain Defence Force Royal Medical Services, Kingdom of Bahrain - specializing in Hand surgery, Burns surgery
and Microsurgery. He is interested in research on Hyperbaric medicine, its application in plastic surgery particularly
in Burns and Trauma. More specifically, his work examines the utility of hyperbaric medicine and its function on
molecular level of wound healing which helps in all spectrum of Plastic surgery.

ABSTRACT
Aim: Snakebite injuries of the extremities are common in tropical India among those involved in
farming and outdoor activities. These injuries often complicated by cellulitis, gangrene, regional
lymphadenopathy, compartment syndrome, bleeding abnormalities, septicemia, hypotension, and
disseminated intravascular coagulation, resulting in significant morbidity and mortality. The purpose
of the study is to share our experience of hyperbaric oxygen (HBO) therapy in the management of
snakebite injuries. Methods: All patients who were treated for snakebite injuries in our department
between October 2012 and October 2013 were included in the study. Results: Out of a total 395 patients,
174 patients treated with anti-snake venom with a mortality of 17 posttreatment. Forty-four out of the
174 patients was in the pediatric age group. Out of the patients referred to our department, 23 presented
with cellulitis, 7 with compartment syndrome and 17 for the management of soft tissue cover over the
extremities. Of the 47 patients, 30 involved the lower extremity and rest involved the upper extremity.
All patients were subjected to HBO therapy as an adjunct. Six patients required flap cover: cross finger
flap (n = 2), anterolateral thigh free tissue transfer (n = 1), lateral supramalleolar flap (n = 1), groin flap
(n = 1), and dorsal metacarpal artery flap (n = 1). There was no need for fasciotomy among the patients
who suffered impending compartment syndrome. Conclusion: HBO therapy may reduce the incidence
of fasciotomy and increase the effectiveness of plastic surgical modalities if administered early and may
be used as a useful adjunct in the management of snake envenomation injury.

Key words:
Hyperbaric oxygen therapy; snake bite injury; soft tissue reconstruction; upper and lower extremity

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How to cite this article: Mukundan PK, Ambookan PV, Angappan R.
DOI: Hyperbaric oxygen therapy improves outcome of snake envenomation:
10.20517/2347-9264.2015.11 tertiary center experience. Plast Aesthet Res 2016;3:59-63.
Received: 03-02-2015; Accepted: 25-11-2015
© 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc. 59