Hand deformities in patients with snakebite

Over the past 25 years, 83 patients have been treated at our hospitals for poisonous snakebites of the hand. Prior to 1970, polyvalent antivenin was used, either alone or in conjunction with cryotherapy, steroids, or incision and suction methods. Hand deformities, due to tissue necrosis, were encountered in 15 of 22 patients (68%) treated by these methods. In contrast, excisional therapy, without the use of polyvalent antivenin, was the sole method of treatment in 61 patients seen since 1970. The incidence of hand deformity in them was 8.2%. We have concluded that early excision of the envenomated tissues will not only curtail systemic toxicity from the injected venom, but will also minimize the extent of local tissue damage.