Thorough debridement and immediate primary wound closure for animal bite injuries of the upper limbs

[Bite Wounds Should not be Irrigated by Syringe. An Anatomic Study]

In the literature about treatment of animal and human bite injuries, it is often recommended that bite wounds should be cleaned with a syringe and button cannula or plastic catheter. This is supposed to clean deeper wound sections and remove contamination and foreign bodies. Recent papers recommend cautious irrigation without high pressure.

MATERIAL AND METHOD

 In eight cadavers, artificial bite wounds were produced in typical locations. These wounds were irrigated by syringe and button cannula using diluted ink. The pressure of irrigation was limited to "no noticeable pressure".

RESULTS

 In all cases, more than half of the irrigation volume remained inside the victim´s organism, following anatomic structures and spreading over large areas.

CONCLUSION

Irrigation fails to clean the wound but increases the risk of contaminating the surrounding structures. Hence, the authors recommend that bite wounds should not be irrigated by syringe and button cannula.

"Cat and dog bite injuries of the hand: early versus late treatment"

INTRODUCTION

Animal bites of the hand are common injuries in the emergency department. Serious complications may occur if those injuries are not treated adequately. The purpose of the study was to examine if there is a difference between the treatment of animal bite injuries at an early stage (first treatment within the first 24 h after injury, group I) versus a later stage (first treatment more than 24 h after injury, group II) retrospectively.

MATERIALS AND METHODS

Between January 2010 and March 2016, a total of 69 patients with cat and dog bite injuries were treated in our hospital emergency room (ER). 45 patients arrived at the ER within 24 h after the injury (group I). 24 patients were treated more than 24 h after injury for the first time (group II). A retrospective study with evaluation of the clinical data including wound aspect, tissue damage, treatment, and antibiotics was performed.

RESULTS

In group I, 27 were outpatients and 18 were in-house patients with an average hospitalization period of 3.3 days ± 1.12 days. 16 patients were treated conservatively. An operation was performed in 29 patients and in 3 patients a second look surgery was necessary. In group II, 5 patients were outpatients and 19 were inpatients with an average hospitalization period of 5.8 days ± 1.9 days. An operation was performed in 22 patients, and 2 were treated conservatively. In five patients, a second look surgery was necessary in group II.

CONCLUSION

The study demonstrates that an early treatment of cat and dog bite injuries leads to less second-look operations and a shorter hospitalization. Hence, animal bite injuries of the hands should be treated immediately to avoid further complications.

LEVEL OF EVIDENCE

Level 3, therapeutic.