​Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite

Mammalian bite wounds are a very common clinical problem across the world. Systematic reviews have been conducted to address the role of education in preventing dog bite injuries in adolescents and children (Duperrex 2009) and antibiotic prophylaxis for mammalian bites (Medeiros 2001). However local wound management, one of the most important aspects in management of mammalian bites has not been evaluated by systematic reviews. The issue of primary closure versus delayed closure for non-bite traumatic wounds has been studied previously (Eliya-Masamba 2013), but this systematic review did not include mammalian bites. The issue of primary closure of animal bites remains controversial (Garbutt 2004), and a systematic review in this regard will help to make an objective assessment of this important question, and enable evidence-based clinical decision-making and guideline development.

A Cochrane Review on this is being conducted by Dr. Soumyadeep B and his colleagues. The protocol for the same has been published and is available here  (Open Access in India by ICMR grant )

Snakebite: a forgotten problem

When Alexander the Great invaded India in 327-325 BC he was said to be impressed by the arrow heads poisoned with lethal venom from the Russell viper and the advanced clinical acumen of Indian doctors in managing snakebite.1 In 2009 the World Health Organization added snakebite to its list of neglected tropical diseases, hoping to reduce its burden on so many marginalised populations.

“We need to act now to deal effectively with this problem, which causes severe disability, brings misery to families, and which kills thousands of people,” said Lorenzo Savioli, director of the department of control of neglected tropical diseases at WHO.2 However, policy makers, clinicians, and the general public have largely ignored the snakebite problem, even though it kills thousands of people each year and causes social, economic, and personal misery to many more.

Ghulam Nabi Azad, the union health and family welfare minister of the government of India, told the Lok Sabha, India’s lower house of parliament, in April 2012 that only 1440 people had died from snakebite in India in 2011.3 WHO, however, predicts as many as 1 841 000 envenomings and 94 000 deaths globally, with India having the most of any country, with an estimated 81 000 envenomings and 11 000 deaths a year.2 The Million Death Study4 estimated some 45 900 deaths from snakebite in India in 2005, about the same number as those from HIV/AIDS.5

Read the full article by Dr. Soumyadeep B at the British Medical Journal

Snake-bite deaths in West Bengal

The Union Health and Family Welfare Minister, Mr Ghulam Nabi Azad, informed the Lok Sabha in April 2012 that there had been a total of 1440 deaths due to snake-bites in India in 2011. He added that as many as 380 of these cases were from West Bengal, 296 from Odisha and 258 from Andhra Pradesh…‘In a nationwide study by Mohapatra et al., it is stated that there are 45 900 snake-bite deaths every year all over the country. The differencesContinue reading “Snake-bite deaths in West Bengal”