Animal bites

Animal bites

Frequency. UK

Risk factors

• • Dogs bite more often in the late afternoon, especially in warm or hot weather, do not like scantily clad people
  • Cats are more likely to bite in the morning
  • Alcohol Intake: Dogs do not like the smell of alcohol.

Clinical picture – bitten wounds are represented by abrasions, scratches, the edges of the wound are traditionally torn, crushed.

Research methods

• • 75% of bite wounds are infected – culture of microorganisms is likely
  • X-ray examination of the affected area to exclude bone damage and follow-up in dynamics when osteomyelitis is suspected.

Treatment:

Surgery

• • Primary surgical treatment of the wound with the removal of non-viable tissues
  • Wound suturing is likely if the bite occurred no more than 12 hours ago, a full-fledged primary surgical treatment was carried out, and also if the surgeon is confident in the improbability of infection in the wound
  • The imposition of primary delayed sutures 3-5 days after the bite is optimal for obviously infected wounds and the improbability of preventing the development of infection only by primary surgical treatment
  • In case of fractures of the bones of the hand, a splint will be required.

Drug therapy

• • The introduction of anti-rabies serum for the prevention of rabies.
  • The introduction of tetanus toxoid (immunized patients, if later in the last vaccination more than 5 years have passed) – see Tetanus.
  • Human tetanus immunoglobulin in incomplete primary immunization (see Tetanus).
  • Preventive therapy in the first 12 hours after a bite
  • Penicillin V (phenoxymethylpenicillin) 500 mg orally 4 times a day (children 50 mg/kg/day orally 2 times a day) for 3 days
  • Other products – amoxicillin 500 mg orally 3 times a day for adults and 40 mg/kg/day 3 times a day

children, or amoxicillin-clavulanate potassium (Augmentin) 250-500 mg orally 3 r / day for adults and 20-40 mg / kg / day 3 r / day for children.

• • At the first signs of infection – Augmentin (until the results of bacteriological studies are obtained).
  • Alternative therapy (prophylactic or empiric) in patients allergic to penicillin
  • doxycycline. Contraindicated in children under 8 years of age, pregnant and breastfeeding women
  • Ceftriaxone or erythromycin. Cephalexin should not be used due to resistant strains of P. multocida
  • Approximately 10% of patients allergic to penicillin develop a cross-allergy to cephalosporins.

Complications

• • Septic arthritis
  • Osteomyelitis
  • Extensive soft tissue damage with scarring and subsequent deformity, sometimes with loss of function
  • Sepsis
  • Bleeding
  • gas gangrene
  • Rabies
  • Tetanus
  • Cat scratch disease.

Forecast. In the absence of complications, the wounds heal by secondary intention after 7-10 days. See also Rabies, Cat scratch disease. Tetanus ICD

• • T14.1 Open wound, body region unspecified
  • T01.9 Multiple open wounds, unspecified