Vet Comp Orthop Traumatol 2013; 26(03): 204-207
DOI: 10.3415/VCOT-12-04-0053
Original Research
Schattauer GmbH

Comparison of primary and delayed wound closure of dog-bite wounds

Z. Xiaowei*
1   Urology Department, Peking University People’s Hospital, Beijing, China
,
L. Wei*
2   Hepatobiliary Department, PekingUniversity Cancer Hospital, Beijing, China
,
H. Xiaowei
3   Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
X. Yunbei
1   Urology Department, Peking University People’s Hospital, Beijing, China
,
L. Zhenhua
1   Urology Department, Peking University People’s Hospital, Beijing, China
,
Y. Yeqing
1   Urology Department, Peking University People’s Hospital, Beijing, China
,
Y. Jiaqi
1   Urology Department, Peking University People’s Hospital, Beijing, China
,
W. Chuanlin
4   Emergency Department, Peking University People's Hospital, Beijing, China
› Author Affiliations
This study was funded by the Peking University People's Hospital Research and Development Funds (RDB 2009-26).
Further Information

Publication History

Received 10 April 2012

Accepted 28 March 2012

Publication Date:
19 December 2017 (online)

Summary

Background: Primary bite wound suturing in the emergency department remains controversial in some cases.

Objective: We conducted a study to investigate the infection rate and cosmetic appearance between primary wound closure and delayed wound closure in dog bite wounds in humans.

Methods: All patients with bite wounds were treated with oral antibiotic medications. We adopted a randomized cohort study, dividing the patients who needed wound closure into two groups: 60 patients for primary closure, and 60 patients for delayed closure, and compared the infection rate and wound cosmetic appearance scores.

Results: In the primary closure group, four people (6.7%) developed a wound infection without systemic infection. In the delayed closure group, three people (5%) developed a wound infection (p = 0.093), but there were not any patients that developed a systemic infection. Thirty-three patients (55%) in the primary closure group had optimal cosmetic scores, whereas 20 patients (33.3%) in the delayed closure group had optimal cosmetic scores (p = 0.012).

Conclusion: Although primary wound closure for dog bites may be associated with a higher infection rate, the cosmetic appearance after primary closure was still acceptable.

* These two authors contributed equally.


 
  • References

  • 1 Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA 1998; 279: 51-53.
  • 2 Wiley JN. Mammalian bites. Review of evaluation and management. Clin Pediatr (Phila) 1990; 29: 283-287.
  • 3 Goldstein EJ. Bite wounds and infection. Clin Infect Dis 1992; 14: 633-638.
  • 4 Lackmann GM, Draf W, Isselstein G. et al. Surgical treatment of facial dog bite injuries in children. J Craniomaxillofac Surg 1992; 20: 81-86.
  • 5 Dire DJ. Emergency management of dog and cat bite wounds. Emerg Med Clin North Am 1992; 10: 719-736.
  • 6 Maimaris C, Quinton DN. Dog-bite lacerations: a controlled trial of primary wound closure. Arch Emerg Med 1988; 5: 156-161.
  • 7 Lindsey D, Christopher M, Hollenbach J. et al. Natural course of the human bite wound: incidence of infection and complications in 434 bitesand 803 lacerations in the same group of patients. J Trauma 1987; 27: 45-48.
  • 8 Guy RJ, Zook EG. Successful treatment of acute head and neck dog bite wounds without antibiotics. Ann Plast Surg 1986; 17: 45-48.
  • 9 Georgiade GS. Wound contimanation. Assessment, prevention, and management. Postgrad Med 1983; 73: 247-254.
  • 10 Rodeheaver GT. Pressure ulcer debridement and cleansing: a review of current literature. Ostomy Wound Manage. 1999; 45 (1A Suppl) 80S-85S 86S-87S.
  • 11 Manning SE, Rupprecht CE, Fishbein D. et al. Human rabies prevention--United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2008; 57: 1-28.
  • 12 Dire DJ, Kietzman LI. A prospective survey of procedures performed by emergency medicine residents during a 36-month residency. J Emerg Med 1995; 13: 831-837.
  • 13 Dire DJ, Welsh AP. A comparison of wound irrigation solutions used in the emergency department. Ann Emerg Med 1990; 19: 704-708.
  • 14 Gosnold JK. Infection rate of sutured wounds. Practitioner 1977; 218: 584-585.
  • 15 Singer AJ, Church AL, Forrestal K. et al. Comparison of patient satisfaction and practitioner satisfaction with wound appearance after traumatic wound repair. Acad Emerg Med 1997; 4: 133-137.
  • 16 Hollander JE, Singer AJ, Valentine S. et al. Wound registry: development and validation. Ann Emerg Med 1995; 25: 675-685.
  • 17 Quinn J, Wells G, Sutcliffe T. et al. Tissue adhesive versus suture wound repair at 1 year: randomized clinical trial correlating early, 3-month, and 1-year cosmetic outcome. Ann Emerg Med 1998; 32: 645-649.
  • 18 Goldstein EJ, Citron DM, Finegold SM. Dog bite wounds and infection: a prospective clinical study. Ann Emerg Med 1980; 9: 508-512.
  • 19 Huo Lin, Han Baojiang, Zhang Yanyan. Investigation of primary wound closure of dog bites. Clinical Emergency Journal [English Translation] 2005; 6: 39-40.
  • 20 Goldstein EJ. Management of human and animal bite wounds. J Am Acad Dermatol 1989; 21: 1275-1279.
  • 21 Brook I. Human and animal bite infections. J Fam Pract 1989; 28: 713-718.
  • 22 Lewis KT, Stiles M. Management of cat and dog bites. Am Fam Physician 1995; 52: 479-485. 489-490.
  • 23 Callaham M. Prophylactic antibiotics in common dog bite wounds: a controlled study. Ann Emerg Med 1980; 9: 410-414.
  • 24 Slonim CB. Dog bite-induced canalicular lacerations: a review of 17 cases. Ophthal Plast Reconstr Surg 1996; 12: 218-222.
  • 25 Chen E, Horing S, Shepard SM. et al. Primary closure of mammalian bites. Acad Emerg Med 2000; 7: 157-161.