Erythropoietin Hydrogel Combined with Open Decompression is Effective in Treating the Rabbit Model of Osteofascial Compartment Syndrome after a Deinagkistrodon acutus Bite

This study aims to evaluate the efficacy of erythropoietin (EPO) hydrogel in treating severe tissue damage caused by Deinagkistrodon acutus (D. acutus) envenomation. Given its potent anti-inflammatory, anti-apoptotic, and tissue-protective properties, EPO directly counteracts key pathological effects of the venom, making it a rational and promising therapeutic strategy for enhancing tissue repair and wound healing in this condition. Twenty-four healthy male New Zealand white rabbits (n = 6) were randomly divided into open decompression (baseline) group, EPO intraperitoneal application group, EPO external application group, and no decompression group. Open decompression was performed in the first three groups. D. acutus venom was injected into the posterior side of the right lower limb. The pressure were measured at DAY (D)1, D3, D5, D7, D11, D15 and D22 after treatment of D. acutus. Both external and intraperitoneal application of EPO hydrogel significantly accelerated wound healing, reduced femoral fascial compartment pressure in the affected limb, and decreased bleeding compared to the open decompression group (p < 0.05). Notably, EPO external application demonstrated a more rapid therapeutic effect in the early phase (days 1-3) compared to intraperitoneal administration (p < 0.05). While no major safety concerns were identified, transient elevations in ALT were observed in the EPO external application group, and certain coagulation parameters (including PT and FIB) differed between EPO-treated and non-EPO-treated groups at specific time points. Overall, EPO hydrogel, when administered via either route, effectively promoted recovery after open decompression for D. acutus envenomation without causing severe adverse effects on vital organ functions.