Snakebite Injuries Research Articles

The effects of hyperbaric oxygen therapy on snake-bite-associated wounds in dogs.

To assess the effect of hyperbaric oxygen therapy (HBOT) on Crotalinae envenomation-induced wound swelling and severity and pain in dogs, and to describe the safety and complications of HBOT. Prospective, randomized, controlled, blinded study (2017-2021). University teaching hospital, private veterinary practice. Thirty-six client-owned dogs presenting within 24hours of a confirmed or suspected naturally occurring Crotalinae snake bite injury were enrolled between 2017 and 2021. In addition to the standard of care treatment, dogs received 2 interventions with either HBOT (n=19) or control (n=16) within 24hours of hospital admission. Dogs receiving HBOT were pressurized over 15 minutes (1psi/min), maintained at a target pressure of 2 atmosphere absolute (ATA) for 30 minutes, and decompressed over 15 minutes. Control dogs received 1 ATA for 1hour. Local wound swelling, wound severity score, and pain score were assessed at admission, before and after each intervention, and at hospital discharge. There was no significant difference in wound swelling (P=0.414), severity score (P=1.000), or pain score (P=0.689) between HBOT and control groups. Pain decreased significantly over time regardless of the study intervention (P<0.001). There were no major adverse effects associated with either study intervention. HBOT did not significantly alter the short-term recovery from Crotalinae envenomation in this study population. However, the study might be underpowered to detect a significant treatment effect.

Comparative efficacy of three wound care approaches in alleviating swelling and pain associated with snakebite wounds in a Chinese hospital

Comparative efficacy of three wound care approaches in alleviating swelling and pain associated with snakebite wounds in a Chinese hospital

Incidence and Risk Factors for Wound Infections after Trimeresurus stejnegeri Snakebites in Taiwan.

Snakebite envenomation is a neglected tropical disease. Taiwan, with its subtropical and Southeast Asian environment, provides suitable habitat for several venomous snake species. Trimeresurus stejnegeri, an arboreal pit viper, is the most common cause of venomous snakebite in Taiwan. Trimeresurus stejnegeri envenomation can cause local swelling, occasional ecchymosis, and wound infection. The primary treatment of T. stejnegeri envenomation is the binary antivenom, vacuum freeze-dried F(ab')2 fragments of equine antibodies, against T. stejnegeri and Protobothrops mucrosquamatus. This study aimed to analyze the incidence of post-envenomation wound infections caused by T. stejnegeri based on data collected over a decade from institutions affiliated with the Chang Gung Memorial Hospital in Taiwan. A total of 254 patients were enrolled in this study. Clinical and laboratory data, treatment information, and patient outcomes were extracted from electronic medical records. Wound infection was associated with delay in antivenom initiation (adjusted odds ratio: 3.987; 95% CI: 1.406-11.302). The infection rates were 20.5%, 12.5%, 31.3%, and 48.1% for antivenom administration within 2 hours, 2-4 hours, 4-6 hours, and > 6 hours, respectively. Therefore, early initiation of antivenom treatment (within 6 hours) is recommended. Morganella morganii was cultured from wounds of the patients, whereas Enterobacter cloacae and Enterococcus faecalis were cultured from both the oral cavity of snakes and the wounds of the patients. For post-envenomation patients who develop a local infection, empiric antibiotics such as third-generation cephalosporins, quinolones, and piperacillin/tazobactam are recommended because snakebite wound infections are often polymicrobial in nature.

Bacterial community analysis identifies Klebsiella pneumoniae as a native symbiotic bacterium in the newborn Protobothrops mucrosquamatus

BackgroundThe study of the native microbiome of organisms is crucial. The connection between the native microbiome and the host affects the formation of the innate immune system and the organism’s growth. However, the native microbiome of newborn venomous snakes has not been reported. Therefore, we aimed to determine the oral and skin microbiomes of newborn Protobothrops mucrosquamatus.ResultsWe performed 16 S full-length sequencing on 14 samples collected from 7 newborn P. mucrosquamatus individuals, specifically targeting their oral and skin microbiomes. In terms of the oral and skin microbiome, the main species were Klebsiella pneumoniae lineages. According to subspecies/species analysis, the proportion from highest to lowest was K. quasipneumoniae subsp. similipneumoniae, K. pneumoniae subsp. pneumoniae, and K. pneumoniae subsp. rhinoscleromatis. These three bacteria accounted for 62.5% and 85% of the skin and oral activity, respectively. The oral microbiome of newborn P. mucrosquamatus did not comprise common bacteria found in snakebite wounds or oral cultures in adult snakes. Therefore, the source of other microbiomes in the oral cavities of adult snakes may be the environment or prey. Functional Annotation of the Prokaryotic Taxa analysis showed that the skin/oral native microbiome metabolism was related to fermentation and human infection owing to the dominance of K. pneumoniae lineages. The characteristics of K. pneumoniae may impact the development of venom in venomous snakes.ConclusionThe results of the native microbiome in the oral cavity and skin of newborn P. mucrosquamatus demonstrated that the habitat environment and prey capture may affect the composition of bacteria in adult snakes. We hypothesized that the native microbiome influences newborn venomous snakes and that K. pneumoniae lineages related to citrate fermentation may play a role in venom growth. However, further verification of this is required.

Namibian spitting cobra, Naja nigricincta nigricincta (Zebra snake): Antibiotic profile of bacteria cultured from the oral pharynx, venom and snakebite wounds.

This was a cross-sectional study with the aim of characterising Naja nigricincta nigricincta's oral bacterial flora as well as accompanying sensitivities and resistance towards antibiotics. Naja nigricincta nigricincta (zebra snake) is a spitting cobra indigenous to Namibia. Nasopharyngeal and venom swabs for bacterial culture and antibiotic sensitivity were taken from 37 native zebra snakes originating from the Khomas region that were captured for removal and relocation. Enterococcus faecalis, Proteus spp., Morganella morganii and Pseudomonas spp. were the organisms most often cultured. The antibiotic sensitivity profiles of these organisms suggest ciprofloxacin or a third-generation cephalosporin plus gentamicin or piperacillin-tazobactam as prophylactic antibiotics in case of Naja nigricincta nigricincta bites.

Clinical Characteristics and Management of Snake Bite Injuries in the Jerusalem Area.

Venomous snake bites can constitute medical emergencies, and without immediate care may be life-threatening. This study describes the characteristics and management of patients suffering from snake bite injuries (SNIs) in the Jerusalem area. A retrospective analysis of all patients who were admitted to the Hadassah Medical Center emergency departments (EDs) due to SNIs between 1 January 2004 and 31 March 2018 was conducted. During this period, 104 patients were diagnosed with SNIs, of whom 32 (30.7%) were children. Overall, 74 (71.1%) patients were treated with antivenom, 43 (41.3%) were admitted to intensive care units, and 9 (8.6%) required treatment with vasopressors. No mortality was recorded. On ED admission, none of the adult patients presented with an altered mental state compared to 15.6% of the children (p < 0.00001). Cardiovascular symptoms were observed in 18.8% and 5.5% of the children and adults, respectively. Fang marks appeared in all of the children. These findings underscore the severity of SNIs and the differences in clinical presentation between children and adults in the Jerusalem region.

Lonomia Obliqua Caterpillar Encounter in Guyana: 29-Year-Old European Tourist Who Develops Coagulopathy

Background: Envenomation cases in Guyana are primarily from snake bite wounds and result in haemorrhagic syndromes developing. Although Guyana shares borders with Brazil there haven’t been published cases of Lonomia obliqua caterpillar encounters. Case Presentation: Here we present the case of a 29-year-old, previously healthy European male tourist who developed haematuria and ecchymosis after stepping on a Lonomia obliqua caterpillar. He had abnormal prothrombin and partial thromboplastin times with no progression to renal failure or intracranial haemorrhage. The venom from these caterpillars affects both the inflammatory and coagulation systems. Treatment with antilonomic serum is recommended and due to pro-thrombotic effects of cryoprecipitate and fresh plasma these are not recommended. Outcome: The patient was admitted and on day two received antilonomic serum which was sourced from Brazil as it was not readily available locally. After a ten-day hospital stay, he was discharged with normalization of his prothrombin and partial thromboplastin times. Keywords: [Lonomia obliqua, Caterpillar, Coagulopathy, Guyana]

Bacteriological Studies of Venomous Snakebite Wounds in Hangzhou, Southeast China.

Snakebite is a common occurrence in Hangzhou, and identifying bacteria in wounds is very important for snakebite treatment. To define the pattern of wound bacterial flora of venomous snakebites and their susceptibility to common antibiotics, we reviewed the medical charts of patients admitted with snakebite at Hangzhou TCM Hospital from January 2019 to December 2020. A total of 311 patients were enrolled in this study. Among them, bacteria culture was positive in 40 patients, and 80 organisms were isolated. The most frequent pathogens were Morganella morganii and Staphylococcus aureus. According to the results of susceptibility testing, a majority of the isolates were resistant to some common first-line antibiotics, such as ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefoxitin, and cephazolin. Quinolones, however, have shown a better antibacterial effect. In conclusion, snakebite wounds involve a wide range of bacteria. Fluoroquinolones, such as levofloxacin and ciprofloxacin, could be an alternative for empirical treatment in patients with snakebite when the effect of other antibiotics is poor.

Complication in Neglected Non-Venomous Snake Bite in Rural Area; What We Need to Anticipate

Snake bite is common condition that lead to great consequence in the rural area of tropical country. Although snakebite is treatable, WHO listed snakebite as Neglected Tropical Disease. Epidemiology data of snakebite not known exactly, the real data may be higher than data inscribed. Both venomous and non-venomous snake are can lead to fatal condition and make the victim consequences morbidity and mortality. Non-venomous snakebite also have potential risk of infection, coagulopathy, and traumatic feelings. Prognosis affected by many factors from snake venom, the victim, and environment that led to delayed medical treatment. Here, we report a case of neglected non-venomous snakebite wound that lead to severe infection of the limb.

Snakebite Treatment in Tanzania: Identifying Gaps in Community Practices and Hospital Resources.

Snakebite envenoming causes more than 140,000 deaths annually and at least triple this number of disabilities. The World Health Organization classified snakebite as a Neglected Tropical Disease in 2017 and developed a strategy to halve death and disability from snakebite by 2030. To achieve this goal, snakebite victims need to receive safe and effective treatment. This descriptive, cross-sectional study surveyed student health professionals (N = 312) in Dar es Salaam, Tanzania, and was designed to identify major gaps in community practices and hospital resources for snakebite treatment. Participants reported using traditional community practices (44%, 95% confidence interval (CI) = 39–50%), allopathic practices (7%, 95% CI = 5–11%), or a combination of both (49%, 95% CI = 43–54%) to treat snakebite. Harmful practices included tight arterial tourniquets (46%, 95% CI = 41–52%) and wound incisions (15%, 95% CI = 11–19%). Many participants (35%, 95% CI = 29–40%) also turned to traditional healers. Students who treated snakebite injuries within the last 5 years (N = 69) also reported their general experiences with snakebite in hospitals. Hospitals often lacked essential resources to treat snakebite victims, and 44% (95% CI = 30–59%) of snakebite victims arrived at a hospital only three or more hours after the bite. A significant percentage of snakebite victims experienced lasting damage (32%, 95% CI = 20–47%) or death (14%, 95% CI = 7–25%). Snakebite outcomes could likely be improved if hospitals were universally and consistently equipped with the essential resources to treat snakebite victims, such as antivenoms. Educational interventions aimed at communities should focus on discouraging tourniquet use and tampering with the wound. Collaboration between the allopathic and traditional health system could further boost snakebite outcomes because traditional healers are often the first health workers to see snakebite victims.

Local Wound Spray of “Standardised Herbal Antibiotic Extract” on Snakebite Wounds along with Routine Anti Snake Venom Treatment Saves Lives, Limbs and Livelihood of Snakebite Victims in Rural Maharashtra, India - 15 Case Reports as Pilot

Background: Globally between 81,000 and 138,000 people around the world die each year from snakebite. Authors noticed that the use of oral/ systematic antibiotics in many snakebite victims failed to heal the snakebite wounds, and either the patients required skin grafting or the bitten part developed necrosis and needed amputation.Objectives: Authors after an extensive literature review thought of neutralising bacteria at the snakebite site by a potent antimicrobial spray, without any side effects.Method: Authors decided to get the antimicrobial profile of herb X and found that it can neutralise the bacteria that are resistant even to the most potent antibiotics available.Results: Herbal extract (234 ml) was prepared for pilot use in snakebite patients. A series of 15 patients were sprayed 2 puffs (7-10 ml) of ready to use herbal spray. None of them developed extensive blisters except the two patients who had mild blisters which resolved subsequently without any deep wound as used to be the case earlier.Conclusion: This pilot project has shown promising results and needs to be applied in more cases in future.

Clinical features and management of snake bites in 70 dogs in Korea.

Snakebites remain a devastating and life-threatening environmental hazard. While the management of snakebites has been well described in humans, few clinical data and guidelines exist for dogs, especially in Korea. This retrospective study evaluated the clinical features of 70 dogs with snakebite wounds in Korea. The medical records of 72 dogs that presented to three animal hospitals from June 2008 to July 2021 were reviewed; among these, 70 dogs that met the inclusion criteria were enrolled. Their signalment, history, clinical signs, physical examination, blood analysis, treatment, and prognosis were also evaluated. Of 70 dog owners, 35 (50%) witnessed the bite, with a mean time between bite and hospital presentation of 9.7 ± 4.1 h in 58 dogs. Blood smears were evaluated in 45 dogs, of which 28 (62%) showed echinocytosis. Anemia and acute kidney injury were found in 21 (29%) and 2 dogs (3%), respectively. A total of 37 dogs (53%) were hospitalized, 5 (7%) of which died. The most significant finding was the high prevalence of echinocytosis. The data from this retrospective study could inform the management of dogs bitten by snakes in Korea.

Maggot Therapy for Snakebite Necrotic Wound in a Horse

Maggot therapy is the use of sterile fly larvae in the treatment of superficial wounds in humans and animals. Lucilia sericata (Diptera: Calliphoridae) larvae are most commonly used for this purpose. Nowadays, larval therapy is widely used in the treatment of diabetic and infectious human wounds. Larval therapy in veterinary medicine has been used in dogs, cats, horses, and even ruminants. A 5-year-old crossbreed (Arabian and Kurdish) stallion was referred to a veterinary private sector in Tabriz city that suffered from a necrotic wound on its forelimb skin following a snakebite injury. The owner had seen the snake in the horse stable. Skin necrosis was observed on the dorsal of the right forelimb which extended to the ventral of the adjacent neck and chest. Despite this extensive skin injury, the horse was alert with a normal appetite and no sign of lameness was detected. Intravenous fluid therapy, systemic anti-inflammatory, and antibiotics were used for the horse's general condition support and topical oxytetracycline and zinc oxide were administered but had no effect on healing of necrotic wounds. Maggot therapy was performed on the necrotic skin. Unfortunately, the larvae died after inserting less than 24 hours. The maggot therapy was unsuccessful in the treatment of skin necrosis in this experience and the larvae died in this short time. However, more clinical trials on the efficacy of maggot therapy for extensive skin necrosis and studies on the effects of snake venom on the maggots are needed.

Pattern of injuries due to wild animal attack among patients presenting to the emergency department: A retrospective observational study

PurposeThe human-wildlife conflicts (HWCs) causing nuisances and injuries are becoming a growing public health concern over recent years worldwide. We aimed to study the demographic profile, mode of injury, pattern of injury, and outcome of wild animal attack victims presented to the emergency department. MethodsThis retrospective cross-sectional study was conducted in the emergency department of a tertiary-care hospital in Eastern India. Data were retrieved from the medical records from May 2017 to May 2021. Patients of all ages and genders attacked by wild animals and secondary injuries were included in this study. Patients with incomplete data, injuries due to the attack of stray and domestic animals and trauma due to other causes were excluded. Demographic profile, mode of injury, the pattern of injury, injury severity score (ISS), radiological pattern, and outcome were recorded. Statistical analysis with R (version 3.6.1.) was conducted. ResultsA total of 411 wild animal attack victims were studied, of which 374 (90.9%) were snakebite injuries and 37 (9.1%) were wild mammalian (WM) attack injuries. The mean age of WM attack victims was 46 years, and the male-to-female ratio was 4:1. Elephant attack injury (40.5%) was the most common WM attack injury reported. Most WM attacks (43.2%) occurred between 4:00 a.m. to 8:00 a.m. The median ISS was 18.5 (13–28), where 54.2% of patients had polytrauma (ISS>15). Elephant attack was associated with a higher ISS, but the difference was not significant compared to other animal types (p = 0.2). Blunt trauma was common pattern of injury in the elephant attack injury cases. Lacerations and soft tissue injuries were common patterns in other animal attacks. Among snakebites, neurotoxic was the most common type (55.4%), and lower extremity was the most common site involved. ConclusionThe young male population is the major victim of HWCs; and elephant is the most common animal involved. There is a need to design scientifically sound preventive strategies for HWCs and to strengthen the preparedness in health establishments to manage victims effectively.

In-vitro Comparative study on blood clotting time of some Plants Extracts and Heparin when Infected with Snakebite

Around the world, snake bite injuries are still life threatening and require intensive care. The diagnose and treatment to toxic snake bites is the insufficient information, within the management of anti-toxin therapy, is not provided in clinical practice. In this comparative study, water extracts of Allium sativum, Allium cepa and Nigella sativa in different concentrations and heparin powder was used on human blood which is free from diseases. The common desert snake poison was used to compare the anti-coagulation time of the above plant extracts. Among three extracts Nigella sativa extract showed more time of coagulation of blood when treated with the snake poison. The results of the present study confirms the traditional medicinal use of selected plants and evidence for the best substances impact in the delay of blood clotting against snake bites of those plants. Further research is going on to isolate bioactive compounds.

MO376CLINICAL OUTCOMES OF ACUTE KIDNEY INJURY FOLLOWING SNAKE BITE INJURIES

Abstract Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p &amp;lt; 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.

Pediatric Snakebites: Comparing Patients in Two Geographic Locations in the United States

BackgroundManagement of children with snakebites may vary based on subjective criteria, geographic, and climatic factors. We reviewed the incidence and management of snakebite injuries in children at two tertiary referral centers in separate geographic and climatic location to assess differences in management and outcomes of these patients. MethodsAfter institutional review board approval, a retrospective chart review was performed for patients ≤18 years with snakebite injuries at emergency departments (ED) of two American College of Surgeons verified trauma centers (2006-2013). One center is in southeast US and experiences a sub-tropical climate whereas the other is in southwest US and experiences a semi-arid climate. Demographic and clinical parameters were extracted. ResultsA total of 108 patients (59% male), median age of 9 y (1 y-17 y), were included. Snake type was identified by bystanders in 55.5% cases; copperhead was the most common (37%) subtype. Approximately 30% of patients received antivenom. One quarter of all patients were discharged from the ED. Two patients received surgical intervention in the first 48 hours after presentation. Compared to patients who sustained a snakebite in semi-tropical regions, patients in semi-arid areas had shorter bite-to-ED time, presented directly to the referral center, were more frequently bitten by a rattlesnake, had longer lengths of hospital stay, required antivenom more frequently and at higher doses, and were more frequently admitted to the ICU. No differences were seen in gender, age at presentation, severity of wound, location of bite, abnormalities in coagulation profile or rate of admission to hospital amongst the two sites. ConclusionsPatients sustaining snakebites in semi-arid climates were more commonly exposed to dangerous snake types, resulting in higher antivenom requirement, as well as longer hospital stays and need for intensive monitoring. Although no fatalities were reported in our study, our data supports early transfer of snakebite victims to higher levels of care, especially in semi-arid or high-risk areas.

SnakeBite Wound with Open Volar Proximal Interphalangeal Joint Dislocation of Little Toe

Snake-bite injuries are uncommon events but a significant number of cases are reported from rural areas. The basic principles of diagnosis and management of snake-bite injuries should be known to rural practitioners and prompt referral should be done in selected cases. The extremity bite may occasionally result in localized cellulitis and soft tissue infection that may complicate later into underlying bone invilement. Dislocation following the open wound in these setting is rare occurrence that needs proper knowledge for its diagnosis and management.

An investigation of conventional microbial culture for the Naja atra bite wound, and the comparison between culture-based 16S Sanger sequencing and 16S metagenomics of the snake oropharyngeal bacterial microbiota.

Naja atra is a major venomous snake found in Taiwan. The bite of this snake causes extensive wound necrosis or necrotizing soft tissue infection. Conventional microbial culture-based techniques may fail to identify potential human pathogens and render antibiotics ineffective in the management of wound infection. Therefore, we evaluated 16S Sanger sequencing and next-generation sequencing (NGS) to identify bacterial species in the oropharynx of N. atra. Using conventional microbial culture methods and the VITEK 2 system, we isolated nine species from snakebite wounds. On the basis of the 16S Sanger sequencing of bacterial clones from agar plates, we identified 18 bacterial species in the oropharynx of N. atra, including Morganella morganii, Proteus vulgaris, and Proteus mirabilis, which were also present in the infected bite wound. Using NGS of 16S metagenomics, we uncovered more than 286 bacterial species in the oropharynx of N. atra. In addition, the bacterial species identified using 16S Sanger sequencing accounted for only 2% of those identified through NGS of 16S metagenomics. The bacterial microbiota of the oropharynx of N. atra were modeled better using NGS of 16S metagenomics compared to microbial culture-based techniques. Stenotrophomonas maltophilia, Acinetobacter baumannii, and Proteus penneri were also identified in the NGS of 16S metagenomics. Understanding the bacterial microbiota that are native to the oropharynx of N. atra, in addition to the bite wound, may have additional therapeutic implications regarding empiric antibiotic selection for managing N. atra bites.

Limb salvage following snakebite using acute limb shortening and secondary lengthening

A case of 16-year-old boy from the remote tribal population of Uttarakhand is described, who sustained a viper snakebite. The patient after various interventions and referrals developed locoregional and systemic complications. He not only had an open tibiofibular fracture but a large bimalleolar defect over his lower limb. The wound infection with underlying osteomyelitis progressed to septic shock and failure of the conventional cross-leg flap. Computed tomography scan of the limb revealed a single patent vessel, eliminating the option of microvascular flap. Limb amputation was considered for source control; however, in an attempt to salvage the limb, the novel approach of acute limb shortening with secondary limb lengthening was performed with parental consent, an approach not previously reported in the management of snakebite injuries. Adequate infection control was achieved following removal of the osteomyelitic bone, and the defect was covered with overlapping tissue from the docked limb and a cross-thigh flap. Secondary lengthening was performed after 3 months, and following extensive surgical and rehabilitative interventions, the boy's limb was salvaged and he retains a near-normal gait. This case report entails a detailed account of how mutilating a snakebite injury could be and how unconventional techniques like acute limb shortening with secondary lengthening can be used in such injuries.