Simple and Effective Approach for Treating Non-healing Ulcers After a Snakebite .

An attempt has been made to develop a simple and effective approach for the treatment of snakebite ulcers using citric acid as the sole antimicrobial agent. Fifty-two (52) cases of snakebite ulcers not responding to conventional antibiotic therapy and local wound care were investigated for culture and susceptibility of swabs collected from the ulcers. Staphylococcus aureus (30.69%) and Pseudomonas aeruginosa (21.78%) were the most common isolates. Ciprofloxacin (61.38%) and amikacin (56.43%) were found to be most effective antimicrobial agents. Determination of susceptibility to citric acid showed MIC in the range of 500-2500 µg/mL. Topical application of citric acid ointment resulted in complete healing in 50 (96.15%) cases. Two cases (3.85%) showed healthy granulation, but wound closure required skin grafting because of large, raw areas. Results indicate that citric acid is the best alternative for the effective management of snakebite ulcers.