Animal bites—should primary reconstruction be the standard treatment? (original) (raw)
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Animal Bites And Reconstruction
The Internet Journal of Plastic Surgery, 2007
Animal bites resulting in significant tissue loss poses unique reconstructive challenge. This article reviews management of series of eleven cases of bite wounds with tissue loss and presents treatment guidelines for the same on the basis of the results.
Management of Animal Bite Wounds on Face: Our Experience
World Journal of Dentistry, 2011
Bite wounds are among the commonest types of trauma to which the man is subjected. Infection is the most common complication in animal bite wounds. The surgical treatment of facial animal bites remains a source of controversy. The controversies continue to center on the timing of wound debridement and primary wound closure as well as the use of antibiotic prophylaxis and primary plastic reconstruction. We report 30 cases of animal bites treated in our department and our protocol in the management of the same.
Maxillofacial Injuries Due to Animal Bites
Journal of Maxillofacial and Oral Surgery, 2013
Introduction Animal bites are a significant public health problem, with the majority of bites coming from dogs, cats and humans. These may present as punctures, abrasions, tears, or avulsions. The force and relative bluntness of the teeth also increases the possibility of a crush injury with devitalized tissue .The clinical presentation and appropriate treatment of infected bite wounds vary according to the animal and causative organisms. These wounds have always been considered complex injuries contaminated with a unique polymicrobial inoculum. Materials This article reviews animal bite wound incidence, bacteriology, risk factors for complications, evaluation components, recommended treatment and prevention based on advanced PUBMED search of the English language literature from the years 1970 to present. Conclusion As the bite wounds are frequently located on the face, an oral and maxillofacial surgeon needs to be familiar with the treatment of animal bites, pitfalls in management and to educate patients on ways to avoid future bite injuries. The management of animal bites is an evidence poor area and most recommendations are based on small case series, microbiological data and expert opinion. The main controversies include whether wounds should or should not undergo primary closure and the use of prophylactic antimicrobials.
Surgical management of a dog bite in a patient with comorbidities. Case study
General Surgery
Millions of people worldwide require urgent medical care annually due to bites and injuries inflicted by wild or domestic animals. Injured patients most frequently suffer from extensive and deep wounds resulting in traumatic shock of different degrees. The extensive wounds are characterized by severe damage to fascial muscles, tendons, bones, major vessels and nerve trunks. Therefore, the management of patients attacked by wild or domestic animals includes the elimination of life‑threatening conditions and the application of various techniques and methods of reconstructive plastic surgery and their combinations to preserve the injured areas of the body (most commonly limbs). In each particular case, the prognosis and the choice of the most effective reconstructive surgery technique for the treatment of a wound defect depend on the state of the deep structures of the injured limb. The «reconstructive ladder principle» ensures the selection of the most appropriate treatment strategy, ...
Primary Repair of Facial Dog Bite Injuries at A Tertiary Centre, Outcome and Review of Literature
IOSR Journals , 2019
Background: Children are the most vulnerable victim of dog bite injury. Face is a commonly affected site and happens during play. It is a potentially life threatening condition as the wound is severely contaminated with Gram positive and Gram negative microorganisms in the saliva of dog. Because of high contamination rate and chance of severe infection, early attention to be paid for the treatment of that wound by means of antibiotics, wound cleansing and debridement. The opinion regarding repair of facial wound is varied. We describe our experience on primary closure of wound with proper precautions. Materials & methods: It is a prospective and observational study of 83 cases of facial dog (all were street dogs) bite injury during October 2014 to February 2017 (2 years and 5 months). All patients were referred from peripheral hospital and we did primary repair in our hospital in every case with proper precaution irrespective of duration of injury. Results analysis: Total 83 cases were analyzed. Among them 62.65% were male and 37.35% were female patients. Commonly affected age group was 2 years to 5 years (50.60%). Different areas of face were affected like cheek, forehead, ear, eye lid, lip, nose scalp and generalised face. Complication rate after repair was 39.75% and most common complication was wound infection. The secondary procedure like secondary stitches, small Z-plasty, skin grafting and injection of steroid for hypertrophic scar were needed in 22.89% of patients. Conclusion: The primary aim is to restore the facial expression by good closure and cosmetically acceptable scar marks. The key to success is proper debridement, anatomical knowledge of face, good tissue handling, closed follow up and antibiotics coverage. So, primary reconstruction of dog bites is possible with good outcome and should be the method of choice.
A study of primary closure of human bite injuries to the face
Journal of Oral and Maxillofacial Surgery, 1997
Purpose.-This study evaluated the management of human bite injuries to the face during the period from May 1995 to April 1996. Patients and Methods: Data on 30 patients presenting with human bite injuries during this period were collected on specially designed forms. The information was pooled and analyzed. A standardized surgical treatment consisting of thorough debridement of the wound followed by primary closure either by direct suturing, a local flap, or skin grafting on the day of presentation was used. Most of the cases were treated under local anesthesia. Patients were prescribed tetanus prophylaxis and a course of antibiotics for 1 week. Suture removal was done 1 week postoperatively except for the skin grafts, which were uncovered at 10 days postoperation. Results: There were 21 males and 9 females ranging in age between 17 and 55 years, with a mean age of 31.8 years. Sixty-six percent of the bites involved the lips. The duration of injury before presentation ranged from 1 to 4 days. In 27 of the cases (90%), wound healing was complete at the time of suture removal. Conclusion: The results indicate that immediate closure of human bite injuries is safe, even with old injuries.
Schweizerische Medizinische Wochenschrift, 2023
BACKGROUND: Animal and human bite injuries are a relevant health problem worldwide. With the increasing number of pets, bite injuries are becoming more frequent. Previous studies on animal and human bite injuries in Switzerland were completed several years ago. The aim of the present study was to provide a detailed overview of patients with bite injuries admitted to a tertiary emergency department in Switzerland in terms of demographics, injury patterns and treatment strategies. METHODS: A 9-year cross-sectional analysis of patients presenting to the emergency department of Bern University Hospital in the period January 2013 to December 2021 following an animal or human bite injury. RESULTS: A total of 829 patients with bite injuries were identified, including 70 for postexposure prophylaxis only. Their median age was 39 (IQR 27-54) years and 53.6% were female. Most patients were bitten by a dog (44.3%), followed by cats (31.5%) and humans (15.2%). Most bite injuries were mild (80.2%); severe injuries were mainly found in dog bites (28.3%). Most patients were treated within six hours after human (80.9%) or dog (61.6%) bites; after cat bites, patients often presented with a delay (74.5%) and signs of infection (73.6%). Human bite wounds were superficial in the majority of cases (95.7%), rarely showed signs of infection (5.2%) at the time of presentation and hospitalisation was never required. CONCLUSIONS: Our study provides a detailed overview of patients admitted to an emergency department of a tertiary Swiss University Hospital after an animal or human bite. In summary, bite injuries are common among patients who present to the emergency department. Therefore, primary and emergency care clinicians should be familiar with these injuries and their treatment strategies. The high risk of infection, particularly in cat bites, may warrant surgical debridement in the initial treatment of these patients. Prophylactic antibiotic therapy and close follow-up examinations are recommended in most cases.
GENITAL TRAUMA DUE TO ANIMAL BITES
The Journal of Urology, 2001
Purpose: Animal bites to the external genitalia are rare. We retrospectively evaluated our experience with treating genital trauma caused by animal attacks.
The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds
The journal of trauma and acute care surgery, 2015
Animal and human bite wounds represent a significant global health issue. In the United States, animal and human bites are a very common health issue, causing significant morbidity and even, in rare scenarios, mortality. Most animal bite wounds in the United States are caused by dogs, with cat bites being a distant second. Human bite wounds constitute a dominant subset of all bite wounds. Several studies of bite wounds have reported improved outcomes with early diagnosis and immediate treatment. However, the available literature on the initial treatment provides a plethora of conflicting opinions and results. In this review, our aim was to identify and assess the current evidence on the management of animal (dog, cat, insects, scorpions, and snakes) and human bite wounds. Review article, level III.
The management of animal bites in the United kingdom
Eplasty, 2013
Animal bites represent a significant global health issue. The evidence in the literature regarding their management in many areas is conflicting and unclear. This project attempts to identify current evidence in the literature on the management of animal bites and assess if current practice in the United Kingdom is evidence based. A literature review on the management of animal bites was performed, and a national UK survey was contacted using a questionnaire based on the available evidence in the literature. The results from this survey show that 98% of plastic surgery units routinely use prophylactic antibiotics in all animal bite wounds; 58% close low-risk injuries primarily after initial washout, and there are conflicting opinions regarding the management of associated fractures and soft tissue injuries. The available data in the literature suggest that appropriate wound management is the most important factor for prevention of infection in animal bites. Antibiotic prophylaxis sh...