Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 2/2016

08.04.2015 | Original Article

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

verfasst von: K. Naito, Y. Sugiyama, Y. Igeta, K. Kaneko, O. Obayashi

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Animal bite injuries are often encountered in daily practice. In particular, these injuries of the upper limbs can result in severe functional impairment. We have performed early debridement of contaminated tissue and primary closure for these injuries.

Methods

The subjects consisted of 15 patients (6 males and 9 females) aged 1–91 years (mean 53.6 years) who visited our hospital due to animal bite injuries (dog in 9 patients, cat in 6). The bite site was the forearm in 5 patients and the hand in 10. In the operating room, contaminated tissue was removed, and primary wound closure was performed after irrigation.

Results

The bite penetrated to the muscle layer in 6 patients, tendon sheath in 5, joint in 1, bone in 1, and involved only the subcutaneous tissue in 3 patients. The mean period until the completion of wound treatment was 19.8 ± 8.4 days. As complications, numbness of finger, metaphalangeal joint contracture and superficial radial nerve injury were observed in each one case. In a patient with bite injury of the palmar and dorsal sides of the thumb reaching the bone, additional debridement was necessary. At the final observation, the visual analog scale was 1.2 ± 1.4, and the Quick Disabilities of the Arm, Shoulder, and Hand score was 9.7 ± 12.2.

Conclusions

Debridement to achieve wound closure is indispensable in patients with animal bite injuries of the upper limbs. The results of our study suggest that thorough debridement allows primary closure, even for animal bite injuries.
Literatur
1.
2.
Zurück zum Zitat Dire DJ, Hogan DE, Riggs MW. A prospective evaluation of risk factors for infections from dog-bite wounds. Acad Emerg Med. 1994;1:258–66.CrossRefPubMed Dire DJ, Hogan DE, Riggs MW. A prospective evaluation of risk factors for infections from dog-bite wounds. Acad Emerg Med. 1994;1:258–66.CrossRefPubMed
3.
Zurück zum Zitat Kountakis SE, Chamblee SA, Maillard AA, Stiernberg CM. Animal bites to the head and neck. Ear Nose Throat J. 1998;77:216–20.PubMed Kountakis SE, Chamblee SA, Maillard AA, Stiernberg CM. Animal bites to the head and neck. Ear Nose Throat J. 1998;77:216–20.PubMed
4.
Zurück zum Zitat Quinn JV, McDermott D, Rossi J, Stein J, Kramer N. Randomized controlled trial of prophylactic antibiotics for dog bites with refined cost model. West J Emerg Med. 2010;11:435–41.PubMedPubMedCentral Quinn JV, McDermott D, Rossi J, Stein J, Kramer N. Randomized controlled trial of prophylactic antibiotics for dog bites with refined cost model. West J Emerg Med. 2010;11:435–41.PubMedPubMedCentral
6.
Zurück zum Zitat Capellan O, Hollander JE. Management of lacerations in the emergency department. Emerg Med Clin N Am. 2003;21:205–31.CrossRef Capellan O, Hollander JE. Management of lacerations in the emergency department. Emerg Med Clin N Am. 2003;21:205–31.CrossRef
8.
Zurück zum Zitat Rui-feng C, Li-song H, Ji-bo Z, Li-qiu W. Emergency treatment on facial laceration of dog bite wounds with immediate primary closure: a prospective randomized trial study. BMC Emerg Med. 2013;13(Suppl 1):S2.PubMedPubMedCentral Rui-feng C, Li-song H, Ji-bo Z, Li-qiu W. Emergency treatment on facial laceration of dog bite wounds with immediate primary closure: a prospective randomized trial study. BMC Emerg Med. 2013;13(Suppl 1):S2.PubMedPubMedCentral
9.
10.
Zurück zum Zitat Rosen RA. The use of antibiotics in the initial management of recent dog-bite wounds. Am J Emerg Med. 1985;3:156–61.CrossRef Rosen RA. The use of antibiotics in the initial management of recent dog-bite wounds. Am J Emerg Med. 1985;3:156–61.CrossRef
11.
Zurück zum Zitat Chaudhry MA, Macnamara AF, Clark S. Is the management of dog bite wounds evidence based? A postal survey and review of the literature. Eur J Emerg Med. 2004;11:313–7.CrossRefPubMed Chaudhry MA, Macnamara AF, Clark S. Is the management of dog bite wounds evidence based? A postal survey and review of the literature. Eur J Emerg Med. 2004;11:313–7.CrossRefPubMed
12.
Zurück zum Zitat Evgeniou E, Markeson D, Iyer S, Armstrong A. The management of animal bites in the United Kingdom. Eplasty. 2013;13:e27.PubMedPubMedCentral Evgeniou E, Markeson D, Iyer S, Armstrong A. The management of animal bites in the United Kingdom. Eplasty. 2013;13:e27.PubMedPubMedCentral
13.
Zurück zum Zitat Schultz R, McMaster W. The treatment of dog bite injuries, especially those of the face. Plast Reconstr Surg. 1972;49:494–500.CrossRefPubMed Schultz R, McMaster W. The treatment of dog bite injuries, especially those of the face. Plast Reconstr Surg. 1972;49:494–500.CrossRefPubMed
14.
Zurück zum Zitat Lee JLH, Buhr AJ. Dog bites and local infection with pasturella septica. Br Med J. 1977;2:169–71. Lee JLH, Buhr AJ. Dog bites and local infection with pasturella septica. Br Med J. 1977;2:169–71.
15.
Zurück zum Zitat Tindall J, Harrison C. Pasturella multocida infections following animal injuries, especially cat bites. Arch Dermatol. 1972;105:412–6.CrossRefPubMed Tindall J, Harrison C. Pasturella multocida infections following animal injuries, especially cat bites. Arch Dermatol. 1972;105:412–6.CrossRefPubMed
16.
Zurück zum Zitat Graham W, Calabretta A, Miller S. Dog bites. Am Fam Physician. 1977;15:132–7.PubMed Graham W, Calabretta A, Miller S. Dog bites. Am Fam Physician. 1977;15:132–7.PubMed
17.
Zurück zum Zitat Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL. Dog and cat bites to the hand: treatment and cost assessment. J Hand Surg Am. 2006;31:468–73.CrossRefPubMed Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL. Dog and cat bites to the hand: treatment and cost assessment. J Hand Surg Am. 2006;31:468–73.CrossRefPubMed
Metadaten
Titel
Thorough debridement and immediate primary wound closure for animal bite injuries of the upper limbs
verfasst von
K. Naito
Y. Sugiyama
Y. Igeta
K. Kaneko
O. Obayashi
Publikationsdatum
08.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 2/2016
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-015-0522-z

Weitere Artikel der Ausgabe 2/2016

European Journal of Trauma and Emergency Surgery 2/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.