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Rhodes IJ, Mwangi MW, Romeo DJ, Rhodes WR, Rohde C. Management of Human Bites in a Rural Kenyan Setting: A Plastic Surgeon's 8-Year Experience. Ann Plast Surg 2024; 92:86-91. [PMID: 37962161 DOI: 10.1097/sap.0000000000003730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION The treatment of human bites is a common issue facing healthcare practitioners in the developing countries of Sub-Saharan Africa where it has been noted as a growing public health concern. Generally, the desired outcomes from surgical management are healing, function, and aesthetics. We share our 8-year experience at Kapsowar Hospital in Kenya with the presentation, management, and outcome of human bites. We are uniquely situated to do so given the prevalence of human biting in our community and the full-time presence of a plastic surgeon at our institution. To the best of our knowledge, this study is the first to present human bite surgical management by a plastic surgeon certified by the American Board of Surgery working full-time on the African continent. METHODS A retrospective chart review was conducted on all patients who presented to the operating theater at Kapsowar Hospital with a human bite between 2013-2021. After identification of eligible patients, charts were reviewed assessing parameters including age, gender, timing from injury to presentation at hospital, localization of bite, severity of facial wounds using Lackmann's classification, surgical procedure(s), postoperative complications, surgical revisions, antibiotics administered, and circumstance of incident. Data were analyzed using SPSS 29.0.0.0. RESULTS Forty-four patients were identified. Seventeen (38.6%) were female and 27 (61.4%) were male. Thirty-one patients had facial bites and 13 patients had bites to other parts of the body. Of facial bites, 70.3% resulted in amputation of the affected part while 29.7% were lacerations. Using Lackmann's classification for facial bite severity, IIIA bites (complete avulsion) were most common for both males (9) and females (7). Females comprised 68.4% of total lip bite victims. Bites to the extremity were associated with late presentation and infection. We report a salvage rate of 85.7% for infected digits. CONCLUSIONS Compared with most other studies on human bites, our patient population presents with a higher rate of avulsive lip injuries, most commonly among women. Our postoperative infection rate is lower than many others reported in the literature. Satisfactory cosmetic outcome with low risk of infection can be achieved by following well-established principles of wound healing and tension-free closure.
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Affiliation(s)
- Isaiah J Rhodes
- From the Columbia University Vagelos College of Physicians and Surgeons, New York City, NY
| | - Mark W Mwangi
- Plastic and Reconstructive Surgery Department, Kapsowar Hospital, Kapsowar, Kenya
| | - Dominic J Romeo
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - W R Rhodes
- Plastic and Reconstructive Surgery Department, Kapsowar Hospital, Kapsowar, Kenya
| | - Christine Rohde
- From the Columbia University Vagelos College of Physicians and Surgeons, New York City, NY
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Na K, Oh BH, Lee J, Cho MJ, Lee M, Kim HR. Penetrating Head Injury Resulting From Wild Boar Attack in Republic of Korea: A Case Report. Korean J Neurotrauma 2023; 19:496-501. [PMID: 38222830 PMCID: PMC10782096 DOI: 10.13004/kjnt.2023.19.e59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 01/16/2024] Open
Abstract
Few cases of injuries caused by wild boars have been reported in the literature. Here, we present the case of a 64-year-old male patient who was attacked by a wild boar. The patient had a laceration to the right forehead and a penetrating wound in the area before the right auricle. Computed tomography scan revealed traumatic subarachnoid hemorrhage, subdural hemorrhage, right temporal lobe contusion hemorrhage, pneumocephalus, right zygomatic arch and temporal bone fracture, and right coronal process fracture of the mandible. Prophylactically, 2,000 mg of ceftriaxone and 400 mg of moxifloxacin were intravenously administered every 24 hours. An emergency craniectomy was performed because the skull fracture was an open fracture and control of the increased intracranial pressure was necessary. Inactivated Rabies Virus Vaccine was also administered postoperatively. We concluded that, unlike typical wounds from other traumatic causes, the risk of wound infection is higher. In order to reduce morbidity and mortality due to wild boar attacks, rapid stabilization of the patient's vital signs, prevention of infection with appropriate antibiotics, and surgical intervention at the appropriate time and method are necessary.
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Affiliation(s)
- Kyunghyun Na
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Byeong Ho Oh
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
| | - JongBeom Lee
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Min Jai Cho
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
| | - MouSeop Lee
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
| | - Hong Rye Kim
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
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Zeaiter N, Maassarani D, Aoun CB, Ghanime G, Sleiman Z. A Rare Presentation of Donkey Bites Involving the Cheek and Ear: A Case Report and Literature Review. Cureus 2023; 15:e37446. [PMID: 37182069 PMCID: PMC10174633 DOI: 10.7759/cureus.37446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
Although animal bites account for a fair number of emergency department visits, donkey bites account for a very limited proportion. A 12-year-old boy presented to our department with a severe donkey bite involving his face. The injury included his left cheek with a laceration of the left ear cartilage. The examination revealed no serious morbidity (no vascular or nerve involvement). The patient received prophylactic antibiotics and anti-rabies/anti-tetanus vaccination. The wound was cleaned thoroughly with copious irrigation. Afterward, the patient underwent surgery to correct the defect in the cheek using a rotational advancement cervicofacial flap, while the penetrated ear cartilage was repaired and the skin margins were approximated and sutured. During the follow-up period, no complications were observed and the functional and cosmetic outcomes were satisfactory. Donkey bites are rarely encountered and they can result in different presentations and morbidities/outcomes. It is suggested that the timing from the bite injury to presentation, the stage/extent of the bite, the use of anti-tetanus and anti-rabies vaccines, and the prophylactic use of antibiotics may play a role in determining the outcomes and/or complications of donkey bites.
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Affiliation(s)
- Nancy Zeaiter
- Plastic and Reconstructive Surgery, Lebanese University, Beirut, LBN
- Plastic and Reconstructive Surgery, Lebanese Hospital Geitawi UMC, Beirut, LBN
| | - Deoda Maassarani
- Plastic and Reconstructive Surgery, Lebanese Hospital Geitawi UMC, Beirut, LBN
| | - Charbel B Aoun
- Plastic and Reconstructive Surgery, Lebanese Hospital Geitawi UMC, Beirut, LBN
| | - George Ghanime
- Plastic and Reconstructive Surgery, Lebanese Hospital Geitawi UMC, Beirut, LBN
- Plastic and Reconstructive Surgery, Lebanese University, Beirut, LBN
| | - Ziad Sleiman
- Plastic and Reconstructive Surgery, Lebanese Hospital Geitawi UMC, Beirut, LBN
- Plastic and Reconstructive Surgery, Lebanese University, Beirut, LBN
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Kalnins NJ, Gibson JS, Stewart AJ, Croton C, Purcell SL, Rajapaksha B, Haworth M. Antimicrobials in dog‐to‐dog bite wounds: A retrospective study of 1526 dog bite events (1999‐2019). J Vet Intern Med 2022; 36:2028-2041. [DOI: 10.1111/jvim.16574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/12/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Nicole J. Kalnins
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - Justine S. Gibson
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - Allison J. Stewart
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - Catriona Croton
- School of Veterinary Science University of Queensland Gatton Queensland Australia
- School of Sciences, Faculty of Health, Engineering and Sciences University of Southern Queensland Darling Heights Queensland Australia
| | - Sarah L. Purcell
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - Bandula Rajapaksha
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - Mark Haworth
- School of Veterinary Science University of Queensland Gatton Queensland Australia
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Kisaka S, Makumbi FE, Majalija S, Muwanga M, Thumbi SM. The potential for the double risk of rabies and antimicrobial resistance in a high rabies endemic setting: detection of antibiotic resistance in bacterial isolates from infected dog bite wounds in Uganda. Antimicrob Resist Infect Control 2022; 11:142. [PMID: 36372895 PMCID: PMC9655799 DOI: 10.1186/s13756-022-01181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-exposure treatment for dog bites in humans aims at alleviating the risk of rabies and promoting wound healing. Wound healing may be complicated by bacteria. This study identified the different bacteria and their antibiotic susceptibilities in infected dog bite wounds (DBWs) in Uganda. METHODS A cross-sectional study was conducted among 376 dog bite patients. Wound swabs from patients with infected DBWs were collected and inoculated into recommended media. They were cultured for both aerobic and anaerobic bacteria. All isolated bacteria were identified based on colony characteristics, gram stain, and standard biochemical tests. Molecular identification was performed for strains that were resistant to three or more antibiotics. Antibiotic susceptibility testing was conducted using the disc diffusion method following the modified Kirby-Bauer method. The data were analysed using Stata version 15 software. RESULTS Approximately half of the patients (52.9%, 199/376) presented with infected wounds. Majority of the swabs (84.4%, 168/199) were culture positive, and yielded a total of 768 isolates where about half (52.9%, 406/768) were gram positive bacteria, and about two-thirds (64.6%, 496/768) were recovered from category II wounds. Among the gram positive bacteria, 339 (83.5%) were aerobes where Staphylococcus aureus (103, 30.4%), Coagulase-negative staphylococci (68, 20.1%), and Corynebacterium spp (33, 9.7%) had the highest prevalence. For the 362 Gram negative isolates, 217 (59.9%) were aerobes and the commonest isolates were P. maltocida (64, 29.5%), Capnocytophaga canimorsus (36, 16.6%) and P. canis (26, 12.0%). Gram-positive isolates were resistant to metronidazole (93.6%), oxacillin (68.5%), ceftriaxone (14.6%) and amoxicillin/clavulanic acid (14.0%). Gram negative isolates were resistant to metronidazole (100%), ampicillin (30.7%), oxacillin (29.3%), and doxycycline (22.9%). Multidrug resistance was in 105 (29.0%) and 121/406 (29.8%) of the gram-negative and gram-positive isolates, respectively. All gram-positive isolates were susceptible to vancomycin and ciprofloxacin. CONCLUSIONS Infection rates of DBWs in Uganda are high and the dominant bacterial isolates are Staphylococcus aureus, Pasteurella spps, and Capnocytophaga canimorsus. Multidrug resistance to commonly used antibiotics is high. The recommendation in the Uganda Clinical Guidelines to use metronidazole in the management of DBWs should be reviewed. DBWs should be enlisted for routine antimicrobial resistance surveillance and rational use of antimicrobial agents should be promoted.
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Affiliation(s)
- Stevens Kisaka
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya.
- School of Public Health, Makerere University, Kampala, Uganda.
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda.
| | | | - Samuel Majalija
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Moses Muwanga
- Department of Medicine, Entebbe General Referral Hospital, Entebbe, Uganda
| | - S M Thumbi
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
- Rabies Free Africa, Washington State University, Pullman, USA
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, USA
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The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries. Injury 2022; 53:1319-1328. [PMID: 35101258 DOI: 10.1016/j.injury.2022.01.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/03/2022] [Accepted: 01/22/2022] [Indexed: 02/02/2023]
Abstract
Animal-related injuries are a substantial but under-reported, emerging public health problem contributing considerably to worldwide morbidity and death. Understanding the behavior of big animals may help in injury prevention. Camels are large long-neck ungulates of the genus Camelus that have been domesticated for millennia as a mode of transportation, race, and food source. Camel-related injuries are not well studied when compared with other animals' injuries. Camels can occasionally be very hostile to humans, inflicting serious injuries. These injuries can be caused by camel bites, falls from their backs, kicks, or collisions with motor vehicles. The relative magnitude of each mechanism has never been extensively studied in the literature. Furthermore, the incidence of camel-related injuries is not well reported worldwide. Camels remain a potential cause of serious injuries and a public health problem for some countries in the Middle East. There are gaps in the incidence, risk factors and mechanism, distribution of camel-related injuries. We aimed to summarize the data and draw conclusions pertaining not just to the most common mechanism of injury but to demographics, incidence, severity, and appropriate methods of prevention of camel-related injuries. This scoping review findings will help for better understanding of the nature and consequences of camel-related injuries, and to improve the existing preventive and management strategies.
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Algorithmic Approach to Antibiotic Prophylaxis for Traumatic Craniomaxillofacial Injuries. J Craniofac Surg 2021; 33:1082-1089. [PMID: 34897199 DOI: 10.1097/scs.0000000000008432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Prophylactic antibiotics are commonly used in the management of traumatic injuries to the maxillofacial complex, yet there are no set guidelines for when and when not to prescribe. The purpose of this review is to present the evidence for antibiotic prophylaxis in different clinical scenarios and to propose algorithms to facilitate the decision making process with the ultimate goal of improving antibiotic prescribing practices. A number of databases were searched using a wide range of keywords to ensure the topic was fully encapsulated. The review is divided into 3 sections: soft tissue trauma, maxillofacial fractures, and ballistic injuries. The algorithms were constructed using the current evidence as well as pathophysiologic principles, especially when there were insufficient studies. This review found the literature on antibiotic prophylaxis to be highly varied and not standardized. Creating an algorithm for providers to follow will help to set a standard of care and decrease the misuse of antibiotics.
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Singh PK, Ali SM, Radhakrishnan RV, Mohanty CR, Sahu MR, Patro BP, Ms I, Panda SK. Pattern of injuries due to wild animal attack among patients presenting to the emergency department: A retrospective observational study. Chin J Traumatol 2021; 24:383-388. [PMID: 34654596 PMCID: PMC8606701 DOI: 10.1016/j.cjtee.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/26/2021] [Accepted: 08/30/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The human-wildlife conflicts (HWCs) causing nuisances and injuries are becoming a growing public health concern over recent years worldwide. We aimed to study the demographic profile, mode of injury, pattern of injury, and outcome of wild animal attack victims presented to the emergency department. METHODS This retrospective cross-sectional study was conducted in the emergency department of a tertiary-care hospital in Eastern India. Data were retrieved from the medical records from May 2017 to May 2021. Patients of all ages and genders attacked by wild animals and secondary injuries were included in this study. Patients with incomplete data, injuries due to the attack of stray and domestic animals and trauma due to other causes were excluded. Demographic profile, mode of injury, the pattern of injury, injury severity score (ISS), radiological pattern, and outcome were recorded. Statistical analysis with R (version 3.6.1.) was conducted. RESULTS A total of 411 wild animal attack victims were studied, of which 374 (90.9%) were snakebite injuries and 37 (9.1%) were wild mammalian (WM) attack injuries. The mean age of WM attack victims was 46 years, and the male-to-female ratio was 4:1. Elephant attack injury (40.5%) was the most common WM attack injury reported. Most WM attacks (43.2%) occurred between 4:00 a.m. to 8:00 a.m. The median ISS was 18.5 (13-28), where 54.2% of patients had polytrauma (ISS>15). Elephant attack was associated with a higher ISS, but the difference was not significant compared to other animal types (p = 0.2). Blunt trauma was common pattern of injury in the elephant attack injury cases. Lacerations and soft tissue injuries were common patterns in other animal attacks. Among snakebites, neurotoxic was the most common type (55.4%), and lower extremity was the most common site involved. CONCLUSION The young male population is the major victim of HWCs; and elephant is the most common animal involved. There is a need to design scientifically sound preventive strategies for HWCs and to strengthen the preparedness in health establishments to manage victims effectively.
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Affiliation(s)
- Pradeep Kumar Singh
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - S Manwar Ali
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | | | - Chitta Ranjan Mohanty
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.
| | - Manas Ranjan Sahu
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Bishnu Prasad Patro
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Ijas Ms
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Susant Kumar Panda
- Department of General Surgery, District Head Quarter Hospital, Angul, Odisha, 759122, India
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Kalnins NJ, Haworth M, Croton C, Gibson JS, Stewart AJ, Purcell SL. Treatment of moderate grade dog bite wounds using amoxicillin-clavulanic acid with and without enrofloxacin: a randomised non-inferiority trial. Aust Vet J 2021; 99:369-377. [PMID: 34151420 DOI: 10.1111/avj.13093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/23/2021] [Accepted: 05/08/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dog-to-dog bite wounds are a common veterinary emergency presentation: despite this, there is insufficient information to guide veterinarians on appropriate empirical antimicrobial management. OBJECTIVES Investigate the effectiveness of amoxicillin-clavulanic acid with and without enrofloxacin in the treatment of moderate grade dog bite wounds (DBW). To describe common pathogens and their antimicrobial susceptibility patterns. MATERIALS AND METHODS In a single-centre parallel group pragmatic trial, 50 dogs presenting with moderate grade DBW were prospectively randomised to receive amoxicillin-clavulanic acid (group A) or amoxicillin-clavulanic acid and enrofloxacin (group B). Swabs were taken for culture and susceptibility testing at admission. Stabilisation, wound care and surgical debridement were performed at the discretion of admitting clinicians. The primary outcome was complication due to infection at 10 days, with Bayesian inference used to estimate the difference in proportions between treatment groups. RESULTS Of the 24 dogs in treatment group A, 1 required the addition of enrofloxacin at re-examination. None of the 26 dogs in group B required alteration of antimicrobial coverage. The difference in complication rate due to infection between treatment groups was 4.2%. Twenty-one different organisms were identified: Staphylococcus pseudintermedius, Neisseria spp., Pasteurella multocida and P. canis were the most common. Over 90% of gram-negative and gram-positive isolates were susceptible to amoxicillin-clavulanic acid. Ninety-six percent of gram-negative and 86% of gram-positive isolates were susceptible to enrofloxacin. CONCLUSION AND CLINICAL SIGNIFICANCE Amoxicillin-clavulanic acid is an appropriate empirical antimicrobial choice for moderate DBW in South East Queensland. Reduced empirical enrofloxacin use will promote antimicrobial stewardship and potentially antimicrobial resistance.
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Affiliation(s)
- N J Kalnins
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - M Haworth
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - C Croton
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
- Faculty of Health, Engineering and Sciences, School of Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - J S Gibson
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - A J Stewart
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - S L Purcell
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
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Eichenauer F, Kim S, Hakimi M, Eisenschenk A, Weber S. [Infections of the Hand after Bite Injuries]. HANDCHIR MIKROCHIR P 2021; 53:237-244. [PMID: 34134156 DOI: 10.1055/a-1382-8093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Bite injuries are common. Along with the resulting complications, they represent approximately 1-2 % of all emergency department visits. In over 75 %, the hands are affected. In Northern Europe, bites and subsequent infections are mainly caused by dogs and cats but also by humans.Up to 40 % of all hand infections are caused to bite injuries. Due to the multiple and complex compartments as well as the low soft tissue coverage of functionally relevant structures, even the smallest and most superficial bite injuries of the hand lead to infections. Any bite injury to the hand may subsequently may result in a fulminant infection and, rarely, even death.The spectrum of pathogens from the oral flora of the biting animal or person is diverse and includes aerobic and anaerobic bacterial strains. Bite injuries represent a major challenge for both the injured person and the attending physician. The rate of complications has been shown to increase with delayed medical consultation, lack of medical care and inadequate wound care. In this review, we discuss the types and complications of bite wounds, their potential risk of infection, their pathogen spectrum and appearance, and their effective treatment.
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Affiliation(s)
- Frank Eichenauer
- Unfallkrankenhaus Berlin; Abteilung für Hand-, Replantations-und Mikrochirurgie
| | - Simon Kim
- Ernst-Moritz-Arndt-Universität Greifswald; Klinik und Poliklinik für Unfall-, Wiederherstellungschirurgie und Rehabilitative Medizin
| | - Mohssen Hakimi
- Vivantes Klinikum Am Urban; Klinik für Unfallchirurgie, Orthopädie und Handchirurgie Berlin
| | - Andreas Eisenschenk
- Unfallkrankenhaus Berlin; Abteilung für Hand-, Replantations-und Mikrochirurgie
| | - Stefan Weber
- Unfallkrankenhaus Berlin; Abteilung für Hand-, Replantations-und Mikrochirurgie
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Tonogai I, Sairyo K. Posterior ankle arthroscopy for posterior ankle synovitis with an enlarged posterior talar process caused by a cat bite or scratch: A case report. Int J Surg Case Rep 2021; 81:105761. [PMID: 33743253 PMCID: PMC8010456 DOI: 10.1016/j.ijscr.2021.105761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/23/2021] [Accepted: 03/10/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Legs are sometimes infected and swollen by cat bite or scratch. However, there is no report of synovitis with an enlarged talar posterior process in the posterior ankle caused by a cat bite or scratch which was treated by removal of the enlarged process and synovectomy with release of the flexor hallucis longus tendon via posterior ankle arthroscopy. PRESENTATION OF CASE The patient was a 58-year-old woman who had started keeping a cat 7 months earlier. She subsequently sustained cat bite and scratch wounds to her lower legs, which gradually became increasingly swollen. On presentation, there was left lower leg swelling, particularly on the posterior aspect of the ankle. Imaging revealed bone marrow edema in the enlarged posterior talar process and inflammation of the adjacent soft tissue. We excised the enlarged posterior talar process, performed synovectomy, and released the flexor hallucis longus tendon using a posterior arthroscopic technique via standard posterolateral and posteromedial portals. Microbial culture was negative. DISCUSSION The patient returned to daily activities approximately 3 weeks after arthroscopic debridement. There was no recurrence at the 1-year follow-up visit. To our knowledge. CONCLUSION We report a rare case of posterior ankle synovitis with an enlarged posterior talar process caused by a cat bite or scratch which was treated successfully by posterior ankle arthroscopic debridement.
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Affiliation(s)
- Ichiro Tonogai
- Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima City, Tokushima, 770-8503, Japan.
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima City, Tokushima, 770-8503, Japan.
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Rahman RA, Gupta UK, Agrawal S, Goel P, Alim M. Diversity of Spectrum and Management of Animal-Inflicted Injuries in the Pediatric Age Group: A Prospective Study from a Pediatric Surgery Department Catering Primarily to the Rural Population. J Indian Assoc Pediatr Surg 2020; 25:225-230. [PMID: 32939114 PMCID: PMC7478280 DOI: 10.4103/jiaps.jiaps_114_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/17/2019] [Accepted: 12/14/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction: Animal-inflicted injuries continue to be a major health problem worldwide. In developing countries, the outcome of such injuries, especially in children may be poor. Aim: The study aimed to evaluate the diversity of spectrum and management of animal-inflicted injuries in the pediatric age group. Materials and Methods: This was a prospective study on animal-inflicted injuries in children between 1 to 15 years of age over a period of 12 months. Data on various parameters such as age and sex, animal species involved, provoked/unprovoked, mechanism of injury, time of injury, prehospital care, injury-arrival interval, pattern and type of injury, trauma score, body region injured, treatment given and complications were collected and analyzed. Results: Fifty-two children with animal-inflicted injuries were included, constituting <1% of all trauma cases seen during the study period (male:female = 2:1). The mean age of the cohort was 9.65 years. Domestic animals were responsible in 41 children (78.84%) and wild animals in 11 children (21.16%). Dog bite was the most common (57.69%). Penetrating injury was observed in 40 (76.9%) and blunt injury was observed in 12 (23.1%). The musculoskeletal system was the most common organ-system injured affecting 36 children (69.23%). Thirty-five children (67.3%) after minor treatment were discharged. Seventeen children (32.7%) required admission. Thirty-four children (65.38%) underwent surgical procedures. Wound debridement was the most common procedure performed. Wound infection was observed in 20 children (38.46%) and was significantly higher (P < 0.01) in delayed presenters. The length of hospital stay for the admitted children ranged from 3 to 28 days. Conclusion: Animal-inflicted injuries are rare in children and have a wide spectrum of presentation. Severe injuries require extensive resuscitation and expert surgical care. Mild injuries can be managed conservatively with the use of proper dressings, antibiotics, and analgesics.
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Affiliation(s)
- Rafey Abdul Rahman
- Department of Pediatric Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
| | - Umesh Kumar Gupta
- Department of Pediatric Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
| | - Shashank Agrawal
- Department of General Surgery, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
| | - Prabudh Goel
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Muniba Alim
- Department of Clinical Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Bhaumik S, Kirubakaran R, Chaudhuri S. Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite. Cochrane Database Syst Rev 2019; 12:CD011822. [PMID: 31805611 PMCID: PMC6894945 DOI: 10.1002/14651858.cd011822.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mammalian bites are a common presentation in emergency and primary healthcare facilities across the world. The World Health Organization recommends postponing the suturing of a bite wound but this has not been evaluated through a systematic review. OBJECTIVES To assess the effects of primary closure compared with delayed closure or no closure for mammalian bite wounds. SEARCH METHODS In July 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We included randomised controlled trials which compared primary closure with delayed or no closure for traumatic wounds due to mammalian bite. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text publications, applied the inclusion criteria, and extracted data. We pooled data using a random-effects model, as appropriate. We used the Cochrane 'Risk of bias' tool and assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We found three trials (878 participants) that compared primary closure with no closure for dog bites and one trial (120 participants) that compared primary closure with delayed closure. No other mammalian bite studies were identified. The trials were from the UK (one trial), Greece (one trial) and China (two trials). Overall, participants from both sexes and all age groups were represented. We are uncertain whether primary closure improves the proportion of wounds which are infection-free compared with no closure, as the certainty of evidence for this outcome was judged to be very low (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.97 to 1.05; 2 studies, 782 participants; I2 = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. There is no clinically important difference in cosmesis (acceptable physical/cosmetic appearance) of dog bite wounds when primary closure is compared with no closure (mean difference (MD) -1.31, 95% CI -2.03 to -0.59; 1 study, 182 participants). The certainty of evidence for this outcome was judged to be moderate (we downgraded our assessment by one level for imprecision). We are uncertain whether primary closure improves the proportion of dog bite wounds that are infection-free compared with delayed closure, as the evidence for this outcome was judged to be very low (RR 0.98, 95% CI 0.90 to 1.07; 1 study, 120 participants; I2 = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. None of the four trials reported any adverse outcomes such as death or rabies but they were, in any case, unlikely to have been large enough to have satisfactory power to provide precise estimates for these. Important outcomes like time to complete wound healing, proportion of wounds healed, and length of hospital stay were not evaluated. AUTHORS' CONCLUSIONS All the studies we identified concerned dog bites. There is no high-certainty evidence to support or refute existing recommendations concerning primary closure for dog bites. The potential benefits and harms of primary closure compared with delayed or no closure for mammalian bites remain uncertain and more robust trials are needed.
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Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health311‐312, Third Floor, Elegance TowerPlot No. 8, Jasola District CentreNew DelhiIndia110025
| | - Richard Kirubakaran
- Christian Medical CollegeCochrane South Asia, Prof. BV Moses Centre for Evidence‐Informed Healthcare and Health PolicyCarman Block II FloorCMC Campus, BagayamVelloreIndia632002
| | - Sirshendu Chaudhuri
- Christian Medical CollegeWellcome Trust Research Laboratory, Division of Gastrointestinal SciencesIda Scudder RoadVelloreTamil NaduIndiaPIN 632004
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Dhillon J, Hoopes J, Epp T. Scoping decades of dog evidence: a scoping review of dog bite-related sequelae. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2019; 110:364-375. [PMID: 30378009 PMCID: PMC6964408 DOI: 10.17269/s41997-018-0145-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/05/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES There has been considerable literature published focusing on various sequelae to dog bites over the last three decades. Much of the literature has focused on rabies, particularly canine rabies variant, which accounts for the majority of rabies deaths worldwide. This paper describes the complications, the pathogens, and other sequelae resulting from dog bites documented in the literature. METHODS This paper used evidence found through a scoping review which charted the published peer-reviewed and non-peer-reviewed gray literature and online information relating to dog bite incidents. Each complication or sequela was additionally assessed from the viewpoint of Canadian Indigenous, rural, and geographically remote communities, which experience a high number of dog bite incidents annually. SYNTHESIS Peer-reviewed literature (N = 693; case report, original research, and review articles) provided detailed information on specific pathogens, infections, and diseases of interest, especially rabies. However, in addition to these, the sequelae from dog bites may include moderate to severe injuries that further result in anxiety around dogs or post-traumatic stress disorder (PTSD). CONCLUSIONS While a lot of focus in the literature is on rabies as a sequela to dog bites, the impacts of anxiety and PTSD are not as well articulated. Treatment of dog bite injuries may be standardized; however, improved collaborations between diverse health professionals (physicians, veterinarians, counseling services, animal behaviourists, and others) could be of considerable benefit in decreasing the effects of dog bites.
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Affiliation(s)
- Jasmine Dhillon
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
- Animal Health Science Directorate, Canadian Food Inspection Agency, 1400 Merivale Rd, Ottawa, ON, K1A 0Y9, Canada
| | | | - Tasha Epp
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada.
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Oguzturk H, Kama A, Mete B, Gungorer B, Ozlem M, Kayipmaz A, San I. Epidemiological and clinical data of patients with stings and bites at a medical center of Turkey. JOURNAL OF ACUTE DISEASE 2019. [DOI: 10.4103/2221-6189.263706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bhat TA, Gulzar A, Bhat AA, Bhat TA, Ali Z. A review of upper limb injuries in bear maul victims: Consistent pattern and inverse relation in severity with facial and scalp injuries. Chin J Traumatol 2018; 21:38-41. [PMID: 29402720 PMCID: PMC5857895 DOI: 10.1016/j.cjtee.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/05/2017] [Accepted: 11/15/2017] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. METHODS Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. RESULTS All the patients had facial/scalp injuries of variable severity. In all the patients the severity of limb and facial trauma was inversely proportional to each other. Pattern of upper limb trauma in most of the patients was similar. Fifteen patients had either fractures of distal humerus or mid shaft/proximal forearm bone fracture. Two had distal forearm bone fracture, 2 had carpal/metacarpal fractures and 1 had clavicle fracture. Only 1 had lower limb fracture. Thirteen out of 21 patients had associated neurovascular injury of the involved limb. The characteristic feature was extensive soft tissue involvement of the affected limb. CONCLUSION Upper limb injuries in bear maul patients usually have similar pattern. The severity of upper limb and facial/scalp trauma is inversely proportional to each other. Multistage orthopaedic surgeries are needed for such complex limb injuries.
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Affiliation(s)
- Towseef Ahmad Bhat
- Department of Orthopaedics, Pt. Jawahar Lal Nehru Govt. Medical College, Chamba, Himachal Pradesh, India,Corresponding author.
| | - Amara Gulzar
- Department of Emergency Medicine, SKIMS Medical College, Bemina, Srinagar, India
| | | | - Tariq Ahmad Bhat
- Department of Orthopaedics, Govt. Sub District Hospital Chadora, Srinagar, India
| | - Zameer Ali
- Department of Orthopaedics, New City Hospital, Srinagar, India
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Jenkins GW, Isaac R, Mustafa S. Human bite injuries to the head and neck: current trends and management protocols in England and Wales. Oral Maxillofac Surg 2018; 22:77-81. [PMID: 29332187 DOI: 10.1007/s10006-018-0670-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/03/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper. MATERIALS AND METHOD A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate. The collated results of the survey were entered onto a spreadsheet (Microsoft Excel©) for the purpose of statistical review. RESULTS A 68% response rate from A&E departments throughout England and Wales demonstrated a lack of consensus in the initial management and subsequent treatment of human bite injuries. Written protocols are in place for human bite injuries in 54.4% of units. In 100% of units, initial management involves irrigation +/- debridement of the wound, though there is a lack of agreement on the surgical management of the wound. 77.9% of units follow 'needle stick protocols' when stratifying risk for blood-borne viruses. CONCLUSION Human bites pose a number of unique problems, ranging from cellulitis to the transmission of communicable diseases. The maxillofacial surgeon has the added dilemmas surrounding subsequent repair and reconstruction. Appreciation of the complexity of human bite injuries will ensure optimal care for the patient. We propose a set of guidelines developed 'in-house' to assist in the management of human bite injuries.
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Affiliation(s)
- Glyndwr W Jenkins
- Sunderland Royal Hospital, City Hospitals Sunderland, Kayll Road, Sunderland, SR4 7TP, UK.
| | - Robert Isaac
- Prince Charles Hospital, Gurnos Road, Merthyr Tydfil, CF47 9DT, UK
| | - Shakir Mustafa
- Prince Charles Hospital, Gurnos Road, Merthyr Tydfil, CF47 9DT, UK
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Arluke A, Cleary D, Patronek G, Bradley J. Defaming Rover: Error-Based Latent Rhetoric in the Medical Literature on Dog Bites. J APPL ANIM WELF SCI 2017; 21:211-223. [PMID: 29068711 DOI: 10.1080/10888705.2017.1387550] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article examines the accuracy and rhetoric of reports by human health care professionals concerning dog bite injuries published in the peer-reviewed medical literature, with respect to nonclinical issues, such as dog behavior. A qualitative content analysis examined 156 publications between 1966 and 2015 identified by terms such as "dog bite" or "dangerous dogs." The analysis revealed misinformation about human-canine interactions, the significance of breed and breed characteristics, and the frequency of dog bite-related injuries. Misinformation included clear-cut factual errors, misinterpretations, omissions, emotionally loaded language, and exaggerations based on misunderstood or inaccurate statistics or reliance on the interpretation by third parties of other authors' meaning. These errors clustered within one or more rhetorical devices including generalization, catastrophization, demonization, and negative differentiation. By constructing the issue as a social problem, these distortions and errors, and the rhetorical devices supporting them, mischaracterize dogs and overstate the actual risk of dog bites.
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Affiliation(s)
- Arnold Arluke
- a Department of Sociology , Northeastern University , Boston, Massachusetts
| | - Donald Cleary
- b National Canine Research Council, Animal Farm Foundation, Inc ., Bangall, New York
| | - Gary Patronek
- c Center for Animals and Public Policy , Cummings School of Veterinary Medicine, Tufts University , North Grafton , Massachusetts
| | - Janis Bradley
- b National Canine Research Council, Animal Farm Foundation, Inc ., Bangall, New York
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Kalchbrenner K. Managing Common Bite Wounds and Their Complications in the United States. PHYSICIAN ASSISTANT CLINICS 2017. [DOI: 10.1016/j.cpha.2016.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVES Little is known about pet-related injuries in Asian populations. This study primarily aimed to investigate the incidence rate of pet-related household injuries in Hong Kong, an urban Chinese setting. SETTING Cantonese-speaking non-institutionalised population of all ages in Hong Kong accessible by telephone land-line. PARTICIPANTS A total of 43 542 telephone numbers were dialled and 6570 residents successfully completed the interviews. PRIMARY AND SECONDARY OUTCOME MEASURES Data of pet-related household injuries in the previous 12 months, pet ownership and socio-demographic characteristics were collected with a questionnaire. Direct standardisation of the incidence rates of pet-related household injuries by gender and age to the 2009 Hong Kong Population Census was estimated. Univariate and multivariate analyses were performed to estimate risks of socio-demographic factors and pet ownership for the injury. RESULTS A total of 84 participants experienced pet-related household injuries in the past 12 months, with an overall person-based incidence rate of 1.28%. The majority of the victims were injured once (69.6%). Cats (51.6%) were the most common pets involved. Pet owners were at an extremely higher risk after controlling for other factors (adjusted OR: 52.0, 95% CI 22.1 to 98.7). Females, the unmarried, those with higher monthly household income and those living in lower-density housing were more likely to be injured by pets. CONCLUSIONS We project a pet-related household injury incidence rate of 1.24% in the general Hong Kong population, with 86 334 residents sustaining pet-related injuries every year. Pet ownership puts people at extremely high risk, especially the unmarried. Further studies should focus on educating pet owners to reduce pet-related injuries in urban Greater China.
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Affiliation(s)
- Emily Y Y Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yang Gao
- Department of Physical Education, Hong Kong Baptist University, Hong Kong SAR, China
| | - Liping Li
- Injury Prevention Research Center, Medical College of Shantou University, Shantou, China
| | - Po Yi Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Shin YC, Shin DM, Lee EJ, Lee JH, Kim JE, Song SH, Hwang DY, Lee JJ, Kim B, Lim D, Hyon SH, Lim YJ, Han DW. Hyaluronic Acid/PLGA Core/Shell Fiber Matrices Loaded with EGCG Beneficial to Diabetic Wound Healing. Adv Healthc Mater 2016; 5:3035-3045. [PMID: 27805803 DOI: 10.1002/adhm.201600658] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/02/2016] [Indexed: 01/13/2023]
Abstract
During the last few decades, considerable research on diabetic wound healing strategies has been performed, but complete diabetic wound healing remains an unsolved problem, which constitutes an enormous biomedical burden. Herein, hyaluronic acid (HA)/poly(lactic-co-glycolic acid, PLGA) core/shell fiber matrices loaded with epigallocatechin-3-O-gallate (EGCG) (HA/PLGA-E) are fabricated by coaxial electrospinning. HA/PLGA-E core/shell fiber matrices are composed of randomly-oriented sub-micrometer fibers and have a 3D porous network structure. EGCG is uniformly dispersed in the shell and sustainedly released from the matrices in a stepwise manner by controlled diffusion and PLGA degradation over four weeks. EGCG does not adversely affect the thermomechanical properties of HA/PLGA-E matrices. The number of human dermal fibroblasts attached on HA/PLGA-E matrices is appreciably higher than that on HA/PLGA counterparts, while their proliferation is steadily retained on HA/PLGA-E matrices. The wound healing activity of HA/PLGA-E matrices is evaluated in streptozotocin-induced diabetic rats. After two weeks of surgical treatment, the wound areas are significantly reduced by the coverage with HA/PLGA-E matrices resulting from enhanced re-epithelialization/neovascularization and increased collagen deposition, compared with no treatment or HA/PLGA. In conclusion, the HA/PLGA-E matrices can be potentially exploited to craft strategies for the acceleration of diabetic wound healing and skin regeneration.
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Affiliation(s)
- Yong Cheol Shin
- Department of Cogno-Mechatronics Engineering; College of Nanoscience & Nanotechnology; Pusan National University; Busan 46241 Korea
| | - Dong-Myeong Shin
- Research Center for Energy Convergence Technology; Pusan National University; Busan 46241 Korea
| | - Eun Ji Lee
- Department of Cogno-Mechatronics Engineering; College of Nanoscience & Nanotechnology; Pusan National University; Busan 46241 Korea
| | - Jong Ho Lee
- Department of Cogno-Mechatronics Engineering; College of Nanoscience & Nanotechnology; Pusan National University; Busan 46241 Korea
| | - Ji Eun Kim
- Department of Biomaterials Science; College of Natural Resources and Life Science; Life and Industry Convergence Research Institute; Pusan National University; Miryang 50463 Korea
| | - Sung Hwa Song
- Department of Biomaterials Science; College of Natural Resources and Life Science; Life and Industry Convergence Research Institute; Pusan National University; Miryang 50463 Korea
| | - Dae-Youn Hwang
- Department of Biomaterials Science; College of Natural Resources and Life Science; Life and Industry Convergence Research Institute; Pusan National University; Miryang 50463 Korea
| | - Jun Jae Lee
- Department of Prosthodontics; Dental Research Institute; School of Dentistry; Seoul National University; Seoul 03080 Korea
| | - Bongju Kim
- Dental Life Science Research Institute; Seoul National University Dental Hospital; Seoul 03080 Korea
| | - Dohyung Lim
- Department of Mechanical Engineering; Sejong University; Seoul 05006 Korea
| | - Suong-Hyu Hyon
- Center for Fiber and Textile Science; Kyoto Institute of Technology; Kyoto 606-8585 Japan
| | - Young-Jun Lim
- Department of Prosthodontics; Dental Research Institute; School of Dentistry; Seoul National University; Seoul 03080 Korea
| | - Dong-Wook Han
- Department of Cogno-Mechatronics Engineering; College of Nanoscience & Nanotechnology; Pusan National University; Busan 46241 Korea
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Abstract
BACKGROUND Animal bites are a major public health problem, it is estimated that 2% of the population is bitten each year. Most bites are by dogs and the risk factors include young children, men, certain breeds of dogs and untrained dogs. The risk of infection after bites differs between animal species and depends on the animal teeth and oral flora. CONCLUSIONS Animal bites are still a major cause of morbidity in patients of all ages and have caused several preventable childhood deaths. These wounds often become infected. If the wound requires it, early surgical evaluation must be performed. The use of antibiotics is only recommended for high risk bite wounds.
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Chen Y, Gao Y, Zhou L, Tan Y, Li L. A Comparative Study of Dog- and Cat-Induced Injury on Incidence and Risk Factors among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111079. [PMID: 27827898 PMCID: PMC5129289 DOI: 10.3390/ijerph13111079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 02/05/2023]
Abstract
Background: Millions of people are bitten by animals each year, with approximately 90% of the injuries being caused by dogs and cats. However, few studies focus on risk factors of dog- and cat-induced injury in China. Therefore, the objective of this study was to investigate the rate of dog- and cat-induced injury and its potential risk factors. Methods: The data were from a population-based cross-sectional study conducted in 2015, with a sample of 9380 children 6-19 years of age from two cities, Shenzhen (large city) and Shantou (mid-sized city), in southern China. Multivariate logistic regression models were used to identify the risk factors of injury by dogs and cats. Results: The total rates of dog and cat-induced injury were 15.1% and 8.7% during the lifetime, and 3.4% and 1.7% during the past year, respectively. Dog bites mostly occurred in the dog's residence (49.4%). Cat scratches were more likely to be inflicted by one's own cat (47.5%). Children living in suburban and island county had 2.83 times and 2.53 times more dog-related injuries than central urban children, respectively. After stratification by cities, injuries in Shantou were correlated with non-single child families (OR (odds ratios), 1.46; 95% CI (95% confidence interval), 1.09-1.96) and raising cats (OR, 5.34; 95% CI, 3.88-7.35). Those who disliked animals (OR, 0.62; 95% CI, 0.45-0.88) or had good academic performance (OR, 0.46; 95% CI, 0.35-0.60) had lower risk for injury. Injuries in Shenzhen were related to the mother's educational level (OR, 1.51; 95% CI, 1.11-2.07) and mother being a migrant worker (OR, 2.10; 95% CI, 1.12-3.94). Conclusions: Family factors were important to predict dog- and cat-induced injury among children from Shenzhen, and personal factors were closely associated with injury among children form Shantou.
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Affiliation(s)
- Ying Chen
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
| | - Yang Gao
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China.
| | - Li Zhou
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
| | - Yafei Tan
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
| | - Liping Li
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
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Lyu C, Jewell MP, Piron J, Ehnert K, Beeler E, Swanson A, Smith LV, Kuo T. Burden of Bites by Dogs and Other Animals in Los Angeles County, California, 2009-2011. Public Health Rep 2016; 131:800-808. [PMID: 28123226 DOI: 10.1177/0033354916675148] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce and prevent animal-to-human bites. METHODS We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health's Animal Bites Database. We collected data on the bite victim's date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal. RESULTS From 2009 through 2011, 26 169 animal-to-human bites were reported, of which 23 103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13 451 (51%), and animal control agencies reported 10 682 (41%). CONCLUSIONS Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.
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Affiliation(s)
- Caleb Lyu
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mirna Ponce Jewell
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Jennifer Piron
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Karen Ehnert
- Veterinary Public Health and Rabies Control, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Emily Beeler
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Veterinary Public Health and Rabies Control, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Alexandra Swanson
- Veterinary Public Health and Rabies Control, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Lisa V Smith
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Tony Kuo
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA; Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Bite wounds and antibiotic prescription among patients presenting to an Australian emergency department. Int Emerg Nurs 2015; 27:42-5. [PMID: 26777255 DOI: 10.1016/j.ienj.2015.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. METHODS A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014. An explicit chart review was conducted to determine management of each case. Cases were subgrouped into high- and low-risk groups as defined by the Australian Therapeutic Guidelines for animal bites. RESULTS There were 160 cases of mammalian bite wounds included, with 143 (89.4%) patients grouped as high-risk and 17 (10.6%) patients identified as low-risk. High-risk features were delayed presentation > 8 hours (57 patients, 35.6%), bites to the head, hand or face (113 patients, 70.6%), and puncture wounds unable to be adequately debrided (74 patients, 46.3%). There was a significant association with delayed presentation of more than eight hours and clinically established infection [OR 36.2; 95% CI: 12.6-103.6; P < 0.001]. Prescriptions for antibiotics that adhered to current guidelines occurred in 99 (61.9%) cases. CONCLUSIONS This study highlights variability in antibiotic prescription practice among clinicians and the need for ongoing education on antibiotic stewardship. Intervention strategies, including ongoing education, are indicated to improve adherence to antibiotic guidelines.
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Bhaumik S, Kirubakaran R, Chaudhuri S. Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite. Hippokratia 2015. [DOI: 10.1002/14651858.cd011822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Richard Kirubakaran
- Christian Medical College; South Asian Cochrane Network & Center, Prof. BV Moses Center for Evidence-Informed Health Care and Health Policy; Carman Block II Floor CMC Campus, Bagayam Vellore Tamil Nadu India 632002
| | - Sirshendu Chaudhuri
- Christian Medical College, Vellore; CHAD; CHAD Hospital, Bagayam Vellore Tamil Nadu India 632002
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Abstract
Animal and human bites are common in the United States. Although evidence-based practice guidelines have not been developed, bite wounds warrant an organized, standardized approach to care to help prevent complications. Such an approach involves first eliciting a history of the circumstances surrounding the bite and the patient's medical history. Next, basic bite wound care should be performed, including cleansing and irrigation of the wound. A good understanding of bite wound bacteriology and the situations in which antibiotics may be indicated is important. Finally, rabies and tetanus prophylaxis should be considered and appropriate follow-up care ensured.
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Affiliation(s)
- Randy A Taplitz
- Division of Infectious Diseases, Oregon Health & Science University School of Medicine, Portland 97239, USA.
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The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. J Trauma Acute Care Surg 2015; 78:641-8. [PMID: 25710440 DOI: 10.1097/ta.0000000000000531] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
UNLABELLED 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. LEVEL OF EVIDENCE Review article, level III.
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Kang H. Animal bite injuries and vaccination. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.3.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyunggoo Kang
- Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea
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Droussi H, El Amrani D, Dlimi M, Elatiqi K, Boukind S, Exadaktylos AK, Weiner S, Ettalbi S. Domestic donkey (Equus africanus asinus) bites: An unusual aetiology of severe scalp injuries in Morocco. Afr J Emerg Med 2014. [DOI: 10.1016/j.afjem.2014.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lin W, Patil PM. Facial dog attack injuries. Indian J Surg 2013; 77:55-8. [PMID: 25829713 DOI: 10.1007/s12262-013-0964-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 08/13/2013] [Indexed: 11/25/2022] Open
Abstract
The exposed position of the face makes it vulnerable to dog bite injuries. This fact combined with the short stature of children makes them a high-risk group for such attacks. In contrast to wounds inflicted by assaults and accidents, dog bite wounds are deep puncture type wounds compounded by the presence of pathologic bacteria from the saliva of the attacking dog. This, combined with the presence of crushed, devitalized tissue makes these wounds highly susceptible to infection. Key to successful management of such wounds are meticulous cleansing of the wound, careful debridement, primary repair, appropriate antibiotic therapy, and rabies and tetanus immunization where indicated. This review presents an overview of the epidemiology, presentation, management of such emergencies, and the recent advances in the care of such patients.
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Affiliation(s)
- Wei Lin
- Department of Burn and Plastic Surgery, Yantai Economic and Technological Development Zone Hospital, Yantai, China
| | - Pavan Manohar Patil
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Plot 32 and 34, Sharda University, Greater Noida, Uttar Pradesh 201308 India
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Esposito S, Picciolli I, Semino M, Principi N. Dog and cat bite-associated infections in children. Eur J Clin Microbiol Infect Dis 2013; 32:971-6. [PMID: 23404346 DOI: 10.1007/s10096-013-1840-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 01/31/2013] [Indexed: 12/25/2022]
Abstract
Millions of people throughout the world are bitten by animals each year. About 90 % of the bites are caused by dogs and cats, and infections are the most common complications. As children are the most frequently bitten subjects, pediatricians should provide parents with everything they need to know in order to confront the problem. However, this does not seem to be case and, as the treatment of bite wounds is frequently inappropriate and delayed, the risk of acute infection and sequelae is increased. The main aim of this review is to discuss the epidemiology, microbiology, and clinical characteristics of infections due to dog and cat bites in children, and suggest the best approach to their management. Analysis of the published literature shows that prompt treatment is necessary in order to reduce the risk of infection. The therapeutic measures include wound washing, specific prophylaxis (i.e., tetanus and/or rabies), and antibiotics in the case of immunocompromised patients or deep wounds (particularly if there is evidence of edema or crushing), facial bites, or any wound over a tendon or bone.
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Affiliation(s)
- S Esposito
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
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Gilyoma JM, Mabula JB, Chalya PL. Animal-related injuries in a resource-limited setting: experiences from a Tertiary health institution in northwestern Tanzania. World J Emerg Surg 2013; 8:7. [PMID: 23374146 PMCID: PMC3565936 DOI: 10.1186/1749-7922-8-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 01/29/2013] [Indexed: 11/23/2022] Open
Abstract
Background Animal related injuries are a major but neglected emerging public health problem and contribute significantly to high morbidity and mortality worldwide. No prospective studies have been done on animal related injuries in our setting. This study was conducted to determine the management patterns and outcome of animal related injuries and their social impact on public health policy in the region. Methods This was a descriptive prospective study of animal related injury patients that presented to Bugando Medical Centre between September 2007 and August 2011. Statistical data analysis was done using SPSS computer software version 17.0. Results A total of 452 (8.3%) animal-related injury patients were studied. The modal age group was 21-30 years. The male to female ratio was 2.1:1. Dog-bites (61.1%) were the most common injuries. Musculoskeletal (71.7%) region was the most frequent body region injured. Soft tissue injuries (92.5%) and fractures (49.1%) were the most common type of injuries sustained. Only 140 (31.0%) patients were hospitalized and most of them (97.1%) were treated surgically. Wound debridement was the most common procedure performed in 91.2% of patients. Postoperative complication rate was 15.9%, the commonest being surgical site infections (SSI) in 55.1% of patients. SSI was significantly associated with late presentation and open fractures (P < 0.001). The overall median duration of hospitalization was 16 days. Patients who had severe injuries, long bone fractures and those with hemiplegia stayed longer in the hospital (P < 0.001). Mortality rate was 10.2% and was significantly high in patients with severe injuries, severe head injury, tetanus and admission SBP < 90 mmHg (P < 0.001). The follow up of patients was poor. Conclusion Animal related injuries constitute a major public health problem in our setting and commonly affect the young adult male in their economically productive age-group. Measures towards prevention and proper treatment and follow up are important in order to reduce morbidity and mortality resulting from this form of trauma
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Affiliation(s)
- Japhet M Gilyoma
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Joseph B Mabula
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Phillipo L Chalya
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
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OCCURRENCE OFPASTEURELLACEAEBACTERIA IN THE ORAL CAVITY OF SELECTED MARINE MAMMAL SPECIES. J Zoo Wildl Med 2012; 43:828-35. [DOI: 10.1638/2011-0264r1.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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36
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Bear attack injury to maxillofacial region: Report of 3 cases and review of management. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2012. [DOI: 10.1016/j.ajoms.2011.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Otariodibacter oris gen. nov., sp. nov., a member of the family
Pasteurellaceae
isolated from the oral cavity of pinnipeds. Int J Syst Evol Microbiol 2012; 62:2572-2578. [DOI: 10.1099/ijs.0.039586-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A total of 27 bacterial isolates from California sea lions and a walrus tentatively classified within the family
Pasteurellaceae
was further characterized by genotypic and phenotypic tests. Phylogenetic analysis of partial 16S rRNA and rpoB gene sequences showed that the isolates investigated formed a monophyletic group, tentatively designated Bisgaard taxon 57. According to 16S rRNA gene sequences, the most closely related species with a validly published name was
Bisgaardia hudsonensis
and the most closely related species based on rpoB sequence comparison was Pasteurella multocida subsp. multocida; highest similarities between the isolates and the type strains of B. hudsonensis and P. multocida subsp. multocida were 95.0 and 88.2%. respectively. All isolates of Bisgaard taxon 57 exhibit the phenotypic characters of the family
Pasteurellaceae
. Members of Bisgaard taxon 57 can be separated from existing genera of the
Pasteurellaceae
by the following tests: positive reactions for catalase, oxidase, Voges–Proskauer and indole; no X- or V-factor dependency; and acid production from l-arabinose (slow), l-fucose, maltose and trehalose, but not from dulcitol, d-mannitol, d-mannose or sucrose. The main fatty acids of Bisgaard taxon 57 (CCUG 59994T) are C14 : 0, C16 : 0, C16 : 1ω7c and the summed feature C14 : 0 3-OH/iso-C16 : 1 I. This fatty acid profile is characteristic of members of the
Pasteurellaceae
. The quinone profile of Bisgaard taxon 57 (DSM 23800T) was similar to that of other genera in the
Pasteurellaceae
. The DNA G+C content of strain Baika1T is 36.2 mol%, which is at the lower end of the range for members of the family
Pasteurellaceae
. On the basis of both phylogenetic and phenotypic evidence, it is proposed that members of Bisgaard taxon 57 should be classified as representatives of a novel species in a new genus, Otariodibacter oris gen. nov., sp. nov. The type strain of Otariodibacter oris is Baika1T ( = CCUG 59994T = DSM 23800T), which was isolated from the oral cavity of a healthy California sea lion in Copenhagen Zoo, Denmark, in 2007.
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Medel N, Panchal N, Ellis E. Postoperative care of the facial laceration. Craniomaxillofac Trauma Reconstr 2012; 3:189-200. [PMID: 22132257 DOI: 10.1055/s-0030-1268516] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The purpose of this investigation is to examine factors involved in the postoperative care of traumatic lacerations. An evidence-based comprehensive literature review was conducted. There are a limited number of scientifically proven studies that guide surgeons and emergency room physicians on postoperative care. Randomized controlled trials must be conducted to further standardize the postoperative protocol for simple facial lacerations.
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Abstract
Human bites are frequently overlooked in making a diagnosis in the emergency room. They are particularly notorious due to the polymicrobial nature of human saliva inoculated in the wound and the risk they pose for transmission of infectious diseases. Early treatment, appropriate prophylaxis and surgical evaluation are the key to achieving desired treatment outcomes. Through this article, we have tried to summarize the diagnostic features, complications as well as the recommended treatment alternatives for human bites based on the current available evidence.
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Affiliation(s)
- Pradnya D Patil
- Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
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Ram R. Maxillofacial Injuries due to Bear Mauling. J Maxillofac Oral Surg 2010; 10:85-9. [PMID: 22379329 DOI: 10.1007/s12663-010-0126-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 10/15/2010] [Indexed: 11/30/2022] Open
Abstract
Bear bite injuries have become a common occurrence as the forest covers and natural habitats are diminishing. Patients injured in bear attack present with different patterns of injuries. A common protocol may not be suitable for the management of injuries inflicted by these large wild animals. These animals usually attack in remote areas where composite trauma centres do not exist and urgent referrals of these patients will have significant effect on the final outcome. Limited literature is available describing bear bite management in maxillofacial practice. The goal of the present case reports is to document the injuries suffered in bear mauling and to add to the literature on the conservative management with minimal complications.
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41
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Mouro S, Vilela C, Niza M. Clinical and bacteriological assessment of dog-to-dog bite wounds. Vet Microbiol 2010; 144:127-32. [DOI: 10.1016/j.vetmic.2009.12.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 12/22/2009] [Accepted: 12/23/2009] [Indexed: 10/20/2022]
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Lichte P, Kobbe P, Taeger G, Nast-Kolb D, Hierner R, Oberbeck R. [Bite injuries of the hand]. Unfallchirurg 2009; 112:719-26; quiz 727. [PMID: 19618153 DOI: 10.1007/s00113-009-1675-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Bite injuries of the hand have a clearly increased risk for infection compared with other regions. Surgical treatment of the wound is indicated, and the debridement must be done thoroughly and with consideration of the wound closure. Antibiotic therapy may be indicated in addition to the surgery if signs of infection exist. Antibiotics alone are not a suitable treatment. Common complications in cases of deficient primary therapy are flexor tenosynovitis, purulent arthritis, and phlegmons of the dorsal hand. These are emergencies and need immediate surgical intervention.
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Affiliation(s)
- P Lichte
- Klinik für Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Deutschland.
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Paediatric open tibiofibular fractures following a donkey bite. A report of two cases. Orthop Traumatol Surg Res 2009; 95:314-8. [PMID: 19502122 DOI: 10.1016/j.otsr.2009.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Revised: 02/14/2009] [Accepted: 04/28/2009] [Indexed: 02/02/2023]
Abstract
Open tibiofibular fractures resulting from domestic animal bites are exceptional. We report two such cases, in patients of 11 and 13 years of age, and discuss the etiological, pathogenic, anatomic, and clinical aspects of these injuries. These were type III fractures according to the Cauchoix and Duparc classification. The fractures were treated with emergency wound care, wound dressing, and conservative orthopaedic treatment using a long leg cast for immobilization. Preventive parenteral antibiotics were also given. Evolution was favorable in both cases and the patients returned to their normal activities with no substantial disability.
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Gaastra W, Boot R, Ho HTK, Lipman LJA. Rat bite fever. Vet Microbiol 2008; 133:211-28. [PMID: 19008054 DOI: 10.1016/j.vetmic.2008.09.079] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 09/19/2008] [Accepted: 09/22/2008] [Indexed: 12/13/2022]
Abstract
Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the infectious agents, their host species, pathogenicity (virulence factors and host susceptibility), diagnostic methods, therapy, epidemiology, transmission and prevention are described. Special emphasis is given on information from the field of laboratory animal microbiology and suggestions for future research.
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Affiliation(s)
- Wim Gaastra
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Comparison of Injury Pattern in Victims of Bear (Ursus thibetanus) and Leopard (Panthera pardus) Attacks. A Study from a Tertiary Care Center in Kashmir. Eur J Trauma Emerg Surg 2008; 35:153-8. [DOI: 10.1007/s00068-008-8085-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Accepted: 07/20/2008] [Indexed: 11/30/2022]
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Okonkwo U, Changulani M, Moonot P. Animal bites: practical tips for effective management. J Emerg Nurs 2008; 34:225-6. [PMID: 18558254 DOI: 10.1016/j.jen.2007.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Revised: 02/16/2007] [Accepted: 04/09/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Ugochuku Okonkwo
- South West London Elective Orthopaedic Centre, Denbies Wing, Epsom General Hospital, KT18 7EG, United Kingdom.
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Shubi FM, Hamza OJM, Kalyanyama BM, Simon ENM. Human bite injuries in the oro-facial region at the Muhimbili National Hospital, Tanzania. BMC Oral Health 2008; 8:12. [PMID: 18447929 PMCID: PMC2397395 DOI: 10.1186/1472-6831-8-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 04/30/2008] [Indexed: 11/30/2022] Open
Abstract
Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5%) frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need multidisciplinary approach.
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Affiliation(s)
- Farrid M Shubi
- Department of Oral Surgery and Oral Pathology, School of Dentistry, Muhimbili University of Health and Allied Sciences (MUHAS) Dar es Salaam, Tanzania.
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Dhar SA, Butt MF, Farooq M, Mir MR, Wani ZA, Afzal S, Sultan A, Wani MI. Pattern of orthopaedic injuries in bear attacks: report from a tertiary care centre in Kashmir. Injury 2008; 39:249-55. [PMID: 18093590 DOI: 10.1016/j.injury.2007.07.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Revised: 06/23/2007] [Accepted: 07/23/2007] [Indexed: 02/02/2023]
Abstract
Interaction between humans and wild animals has increased in recent times, because of overlap of habitats. A proportion of this interaction is violent. Most of the literature describing the injuries sustained by humans in such contact pertains to the involvement of soft tissues. Trauma to bones and joints is only witnessed when larger animals attack humans. We studied the pattern of orthopaedic injuries over a period of 2 years in a series of 32 cases presenting to our hospital with a history of being attacked by the Asian black bear (Ursus thibetanus). This paper also documents the complications and challenges involved in managing these injuries. We suggest that orthopaedic traumatologists need to be prepared to deal with such cases in areas where interaction between humans and large wild animals is manifest.
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Affiliation(s)
- Shabir Ahmed Dhar
- Hospital for Bone and Joint surgery, Barzullah, Srinagar, Kashmir 190005, India.
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Abstract
The acute wound presents a spectrum of issues that prevent its ultimate closure. These issues include host factors, etiology, anatomic location, timing, and surgical techniques to achieve successful wound closure. Basic surgical principles need to be followed to obtain stable, long-term coverage, ultimately restoring form and function. Recent advances in dressings, debridement techniques, and surgical repertoire allow the modern plastic surgeon to address any wound of any complexity. This article discusses these principles that can be applied to any wound.
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Affiliation(s)
- Charles K Lee
- University of California, San Francisco, 350 Parnassus, Suite 509, San Francisco, CA 94117, USA.
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