ALT Flap Allo-transplantation saves post Viper snake bite leg defect


One 30 years old Male was recently brought to Orange City Hospital & Research Institute- a unit for Ravi Nair Hospitals Private Limited at 1.30 am in night in emergency with alleged history of Snakebite on Left foot. As per history given by him, while working in MSEB office at Saleragaon, Samudrapur, Viper snake bite on his left foot around 8.30 pm. He received First aid treatment at PHC, Girad. As Viper venom is very dangerous, it causes immediate swelling and pain in Lt. Leg and later gangrene in Lt. Foot. Being aware of the critical care readiness at OCHRI; his colleagues rushed him here. He was admitted under the care of Dr. Rajesh Atal- Critical Care Physician and Dr. Gaurav Jannawar- Plastic Surgeon. Therapeutic dose of Anti snake venom (ASV) was immediately started with other supportive treatment as per protocol. After thorough investigations, he was diagnosed as Vasculotoxic (Viper) snake bite with Left Lower Limb Cellulitis with gangrene with Acute Kidney Injury.

The patient had a large post snake bite Gangrene and cellulitis defect over Lt. Ankle. A successful tissue allotransplantation using free ALT flap and serial debridement & dressing was carried out by Dr. Gaurav Jannawar, while Dr. Neeta Deshpande and Dr. Anita Pande- Anaesthetists provided necessary anesthesia.

Dr. Gaurav Jannawar informed that “Conventional dressings would take months to heal and skin grafting would have caused late development of contracture. Hence state of art tissue Allo- transplant using thigh flap with microvascular anastomosis helped in speedy recovery in this patient. Early surgical intervention by removing the local bite area prevented the spread of gangrene in Lt. Foot.

Dr. Rajesh Atal said that “Early medical management with ASV helped patients in early stabilization.” Snake bites often occur in remote locations far from medical centers, and anti-venoms are expensive, require refrigeration, and demand significant expertise to administer and manage, he further added.

Udaybhaskar Nair- NAIRSONS Chairman stated that such lifesaving acts by TEAM OCHRI justifies commencement of OCHRI in memory of his late brother Ravi Nair not to earn profits for Nair family but only to save lives.

The patient has now been successfully treated and discharged. Nagpur based OCHRI is among the few critical care centers which has anti-snake venom (ASV) treatment available 24×7 along with hospital stationed round the clock trained group of Critical care specialists for rendering timely treatment. ASV is the medically recommended line of treatment for snake bites and if administered at the earliest can effectively save life.