Integrated approach in managing necrotizing spider bite wound – A case report

Abstract

Background: Spider bites from venomous species may result in progressive necrosis and delayed wound healing due to cytotoxic and hemotoxic effects of the venom. Conventional management includes antiseptics, antibiotics, and debridement, but outcomes are often unsatisfactory. Ayurveda describes Lūṭā Viṣha and offers detoxification and tissue-regenerative approaches that may complement modern care. CasePresentation: A 21-year-old female presented with a necrotizing ulcer on the inner thigh following a spider bite. The wound worsened after initial allopathic treatment, showing increasing necrosis, pain, swelling, and secondary infection. Interventions: Initial first aid involved irrigation with hydrogen peroxide, povidone-iodine application, and sterile dressing. An integrative protocol was then adopted. Internal medicines included Triphala Guggulu for detoxification, Zinc–Vitamin C–Vitamin D supplementation for collagen synthesis, and Guduchi–Manjistha decoction for immunomodulation. External applications comprised Triphala Kwath wash with Neem and Haridra for antisepsis, Yashtimadhu Ghrita for regeneration, and Dashanga Lepa for wound healing. Outcomes: The wound was assessed with the Bates–Jensen Wound Assessment Tool. Within 15 days there was near-complete resolution of necrotic tissue, significant reduction in infection, well-formed granulation tissue, and accelerated epithelialization. The patient reported marked pain relief and improved satisfaction. Conclusion: This case demonstrates the potential benefits of an integrative approach that combines modern first aid with Ayurvedic interventions in managing necrotizing spider bite wounds. Broader clinical studies are warranted to validate these findings and support evidence-based integration.