Talk:Dog bite

References: with notes

O'Brien CM. Richard B. A surgeon's duty in dog bite prevention in children. Annals of Plastic Surgery. 56(1):106-7, 2006 Jan. UI: 16374108An audit of dog bite referrals to the Plastic Surgery Department at Birmingham Children's Hospital revealed the following concerns: 28 consecutive children referred to the plastic surgery team were prospectively audited. The mean age was 6 years. Twenty-two children required surgery. Nineteen of the total had suffered dog bites to the face. Eighteen of the attacks were witnessed and unprovoked. Seventeen dogs were either a family pet or known to the child (eg, belonged to a neighbor or grandparent). Following the attack, 12 dogs remained in the home with the child, 2 dogs were sent to a different home, 2 were taken to the Royal Society for the Protection of Cruelty to Animals, 7 were destroyed, 1 was muzzled, and the fate of 4 is unknown. Of the 7 dogs that were destroyed, 3 were family pets and 4 were known to the child. Six children had been bitten before, and 3 by the same dog. All of those children required surgery. In 5 cases, owners admitted that their dog had bitten before. The most common type of dog to bite in this series was a crossbreed (9 cases), followed by Staffordshire bull terrier (4 cases).Is there not a duty for practitioners to provide advice to prevent repeat attacks on children, particularly by the same animal in the home Birmingham Children's Hospital Birmingham, UK

Soueid NE. Khoobehi K. Microsurgical replantation of total upper eyelid avulsion. Annals of Plastic Surgery. 56(1):99-102; discussion 102-3, 2006 Jan. UI: 16374105 22yo woman attacked by her own dog, who completelt removed her eyelid, which (brought in by a family member) was replaced.

Chaudhry MA. Macnamara AF. Clark S. Is the management of dog bite wounds evidence based? A postal survey and review of the literature. European Journal of Emergency Medicine. 11(6):313-7, 2004 Dec. UI: 15542987 Objectives: To determine current practice in the management of dog bite wounds with regard to the use of prophylactic antibiotics and primary closure and to compare the available evidence.Methods: We conducted a national postal survey of Accident and Emergency (A&E) departments in the UK to ascertain the current practice in the management of recent dog bite wounds. A questionnaire was designed and posted to a named A&E consultant. Non-respondents were sent a single reminder 8 weeks after the initial mailing. A detailed literature search was carried out using Medline, Embase and Cochrane databases to look at the available evidence. Results: The postal survey yielded an 80% response. Prophylactic antibiotics were routinely used by 53% of the respondents. Although 99% of the respondents were happy to close facial dog bite lacerations, 60% were reluctant to suture other body regions. Recent available evidence suggests that restricting the use of prophylactic antibiotics for high-risk dog bite wounds and the primary suturing of appropriate dog bite lacerations is safe.Conclusions: The management of recent dog bite wounds is not entirely evidence based in many A&E departments in the UK.

• "Dog bites account for 80–90% of all animal bites, and 10% of these require suturing" (Dire DJ, Quick G. Dog-bite wounds. Emerg Dec 1986; 2:38–46.)
• The evidence regarding the role of primary closure in dog bite wounds is very limited. Maimaris and Quinton [12] reported a prospective RCT (2b) of 96 patients with 169 wounds to assess infection and cosmesis. The patients were then randomly assigned into two groups: one group had primary wound closure and in the other group wounds were left open. No antibiotics were used. All the patients were reviewed by one of the authors at 2, 7 and 14 days from injury. Out of 92 wounds sutured, seven wounds developed infection. Of 77 wounds left open, six got infected. Statistical analysis showed no significant difference in the infection rates. This was in agreement with three other studies [5,19,20] that have shown a lower infection rate in dog bite wounds that were sutured in comparison with wounds that were left open.The recent available evidence favours the suturing of facial dog bite lacerations. In other body regions, clean deep lacerations with minimal contusions may be sutured after copious irrigation and meticulous debridement if patients present within 4 h.
• There are no good studies of dog bite that include follow-up and a large number of patients that demonstrate worth of prophylactic antibiotics in dog bite. Such studies are needed.

Deshmukh PM. Camp CJ. Rose FB. Narayanan S. Capnocytophaga canimorsus sepsis with purpura fulminans and symmetrical gangrene following a dog bite in a shelter employee. [Case Reports. Journal Article] American Journal of the Medical Sciences. 327(6):369-72, 2004 Jun. UI: 15201655

Healthy young woman dies from septicemia after being bitten by dog at shelter where she volunteers: purpura fulminans with symmetrical peripheral gangrene and sepsis caused by Capnocytophaga canimorsus. Did not seek treatment until 3 weeks after bite on hand."Cases of C. canimorsus infection have been reported from the United States, Canada, Europe, and Australia. Infection occurs 2 to 3 days after wound contamination, but symptoms may appear after 2 to 4 weeks. Patients presenting longer than 8 hours after injury usually have established infection."

Peters V. Sottiaux M. Appelboom J. Kahn A. Posttraumatic stress disorder after dog bites in children.Journal of Pediatrics. 144(1):121-2, 2004 Jan.