h/o unknown bite?? snake ?? insect. before 1 month. discharging pus. pain is mild extremity working properly. what could be possible cause and further management.


Do the debridement and daily dressing. After proper granulation tissue do the skin grafting
I agree with the line of treatment.

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Irrespective of bite , presently lesion is due to infection. 1 Debridement 2 frequently EUSOL dressing 3 rule diabetes mellitus and immunocompromised condition
4 High protein diet 5 if sign of cellulitis, broad-spectrum antibiotics with metronidazole 6 send debrided tissue or pus for culture sensitivity 7 collagen dressing may also help 8 onc granulation start , graft

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The current lesion is gangrene of skin with variable deep tissue involvement. It may due to various toxins released at the time of bite. Rule out diabetes. Start broad spectrum antibiotics. Debridement of all unhealthy tissue and pus till healthy tissue is seen. Regular dressings. As tendons will be exposed, full thickness skin graft / cross over flap will be required to prevent contracture on joint area.
Most probably a Saw-scaled viper bite. Agree with yudhvir Singh sir on the management part.
insect bite, neglected proper treatment, ,septic wound, needs daily dressing , antibiotic cover, protein suppliments,analgesics ,anti inflammatory drugs. Ayurveda line of treatment with , appllication of honey for lekhan + nimb tail application, proteinous diet, sukshm trifalla, use available some of the kushtaghn, shothaghn & jivnay dravyas iin ghan form internally anupan dashmool+ triphala + manjishtha quath . lastly skin grafting even can be consider accordingly.
a case having an ulcer on anterolatral part of rt ankle &dorsum of foot. covered with gangrenous materials. It might have been caused by vasculotoxic snake bite. survived due to tt or dose of poison below LD 50. ??rx accordingly with meticulous debridement of lesion with dressing. investigation. cbc. rbg. lft . rft. to be done. systemic broad spectrum antibiotic and analgesic. vit C. tt as per dx. full thickness skin graft later. ..
first take detailed history whether lesion progressed to present state or developed suddenly debridement of tissue under anaesthesia with freshening of margins after ruling out osteomyelitis and examine pulses too before procedure rule out DM give regular eusol dressing then normal saline dressing once slough is removed then can plan for ssg or let it heal by granulation
I think it is saw scaled viper bite. minimal toxin can induce such swelling which on no treatment gives such picture after 7 to 8 days. line of treatment is same as above. no ASV required.
sterile pressure dressing should be done WD injectible pipracillin tazobactum4.5 t.d.s daily at DAT time filling of skin..
I think it can be gangrene due to toxic spider bite. rest agree with Yudhvir sir for treatment part
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