Effect of snake bite bandaging on superficial lymphatic transit in the lower limb using ICG lymphography

<p dir="ltr">Snake bite bandaging is an integral part of the acute management of snake bites in Australia. There is controversy as to whether bandaging is in fact an effective means to slow lymph flow and the subsequent transit of venom through the lymphatics (Isbister et al., 2013; Van Helden et al., 2019). With the ability to visualise lymph flow in real time via Indocyanine Green (ICG) Lymphography, this study has been designed to investigate the effects of recommended Australian snake bite guidelines in ICG visualised lymph vessels.</p><p dir="ltr">Current guidelines instruct pressure immobilisation bandaging to be performed in a distal (from toes) to proximal (to groin) direction if bitten in the limbs. As the management for the facilitation of lymph flow in lymphoedema is also in a distal to proximal direction, this may provide a conflict in treatment rationale. The development of a means of determining the efficacy of management for acute snake bites has significance around the world.</p><p dir="ltr">This study assesses advocated guidelines comparing to ICG observed lymph flow, to pave a pathway for further research and determine best practice first aid acute management of snake bites in the field, prior to transfer to a medical facility.</p>