Fig 1 - uploaded by Sunil Sidana
Content may be subject to copyright.
Source publication
The exposed position compounded by the short stature of children makes the face very vulnerable to dog bite injuries. Unlike wounds inflicted by assaults and accidents, animal bite wounds are distinctive as they are puncture type deep wounds which are injected by the bite force, with an inoculum of pathogenic bacteria from the saliva of the attacki...
Similar publications
Background
To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children’s maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and pa...
The purpose of this article is to present a case series of facial dog bites injuries, its management and emphasize the importance of primary closure. Animal bite injuries, unlike wounds caused by assaults and accidents, are more distinctive, as they cause deep puncture wounds. Such wounds are inoculated with pathogenic bacteria from the saliva of t...
Citations
... The force delivered by an adult dog jaw can be as high as 450 lbs/sq inch. 2 Such a high quantum of force delivered by the sharp teeth of these mammals can result in three main types of soft tissue wounds-punctures, lacerations, and avulsions with or without actual tissue defect. The mechanism of dog bite injury involves an initial bite with a puncture-type wound with pulling force by a dog, and the reflex mechanism of the victim to get away from the animal acts synergistically, leading to the tearing of the soft tissue calling this "hole and tear" effect. ...
Background : Facial dog bite injuries result in significant emotional, psychological, and physical trauma to the victims involved and should be considered a significant health issue. The purpose of this study is to share our experience in the management and to add to the existing medical literature regarding the epidemiological patterns of facial dog bite injuries.
Materials and Methods : This is a single-center retrospective observational study conducted at Dr. RML Hospital, New Delhi, from January 2021 to January 2022. A total of 105 patients were included. The wounds were managed according to the recommendations made by the national rabies control program and surgical intervention was performed in the form of primary suturing or flap cover.
Results : Children of age group 0 to 10 years are most commonly affected. Pet dogs are the cause in 61% of cases and 57.1% of bites were provoked. Midface is most commonly affected and modified Lackmann's class 3A and 3B are the most common wounds.
Conclusion : In view of raising incidence of dog bites with pet dogs, the general public needs to be educated regarding the practices to prevent these injuries. Postexposure prophylaxis should be given to all affected individuals irrespective of the vaccination status of the dog. Immediate surgical intervention gives better results.
... effect'. [1] In this 'hole and tear' effect, canine teeth hold the victim whereas other teeth bite, shear and tear the tissues resulting in stretch lacerations. [5] Facial animal bite wounds were classified by Lackmann et al. based on the extent of injury [ Table 1]. ...
... In more than 50% cases, anaerobic organisms cause infection. [1,7] Facial animal bite injuries pose a challenge from the point of aesthetics, infection and function. Hence, the goal of maxillofacial rehabilitation should be restoring the aesthetic and functional defects of the patient. ...
... Animal bite wounds are quite distinctive from wounds which are inflicted by human assaults and accidents. These wounds can be puncture type deep wounds, injected by the bite force [1] or may range from minor scratches to major trauma to face involving skin and deep tissue injuries or sometimes, fracture of facial bones. [2] These injuries are always considered complex injuries and highly susceptible for infection due to inoculation of pathogenic microorganisms from the saliva of attacking animal and also due to the presence of devitalised tissues. ...
Animal attacks and bite injuries are common occurrences as the natural habitat of animals is diminishing due to human encroachment. Individuals injured in animal attacks present with different types of injuries. Urgent and effective management of these injuries would have a significant effect on the final outcome. Rabies is a fatal disease in humans, and, till date, only those that received vaccination before the onset of illness survived this disease. The goal of the case reports presented in the article was to document the injuries suffered in animal bite injuries and add to the literature on the management with minimal complications.
... Some authors recommend normal saline as the preferred irrigant for dog bite wounds as it does not interfere with wound healing in contrast to povidone-iodine or ethanol [22]. It remains to be determined whether an attempt should be made to irrigate bite puncture wounds as their small cutaneous openings do not permit the solution to drain out adequately and attempts at irrigation may in fact result in infiltration. ...
... Traumatic avulsion involving the lip vermilion and the perioral composite soft tissue, even with injuries including delicate anatomic landmarks, healing by secondary intention can be instituted as the initial treatment of choice in younger patients often providing optimal results [24]. Large avulsive wounds with tissue loss where primary repair is not possible can be managed with local or regional flaps, skin grafts, or microvascular reconstruction [22]. ...
... Disease progression is characterized by the prodromal phase, encephalitis, and brain stem center dysfunction. In the final stages, spasm of the muscles of deglutition leads to the classical clinical presentation of "foaming mouth" [22]. Finally, complete paralysis, coma, and respiratory distress lead to death. ...
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.
Position of face in head and neck region make it more exposed as comparison to other region to dog bite injuries. Combination of this fact along with short stature of children make them more prone to dog bite. The surgical approach regarding dog bite injury continues to be debatable. Main controversial topic of discussion in animal bite cases is the ideal time for wound debridement along with initial wound suturing as well as the use of prophylactic antibiotics. Early management, most appropriate prophylaxis in addition to precise evaluation are definitely critical for attaining desired results. This case report is to throw a light on epidemiology, presentation, management and recent advances in case of emergency like animal bite.
The purpose of this article is to present a case series of facial dog bites injuries, its management and emphasize the importance of primary closure. Animal bite injuries, unlike wounds caused by assaults and accidents, are more distinctive, as they cause deep puncture wounds. Such wounds are inoculated with pathogenic bacteria from the saliva of the attacking dog due to the penetration of tissue by excessive bite force. Hence, these wounds are at a high risk of infection. The key point in its management is thorough cleansing, meticulous but not overzealous debridement, followed by rabies immunization, tetanus immunization, primary closure, and appropriate antibiotic therapy. A retrospective study of 27 cases that underwent primary repair or reconstruction after wound toilet, debridement and administration of prophylactic antibiotics has been presented.
