Management of animal bite injuries of the face: experience with 94 patients.
OBJECTIVE
Because of the large number of bacteria in the oral cavity, animal bite wounds are generally contaminated, and their treatment is difficult because of the risk of infection, especially in extensive injuries. This report describes the management of a large series of patients and recommends treatment guidelines on the basis of the results.


METHODS
Ninety-four animal bite wounds on the face and head were analyzed according to the type of animal, location and extent of the soft tissue wound, duration and type of surgical treatment, occurrence of infections and their pathogen spectrum, as well as the choice of antibiotic therapy.


RESULTS
Dogs caused 91% of the bite wounds. Infections developed in 4 of 53 patients who underwent primary wound closure with minor edge excision and prophylactic administration of oral penicillin. Without antibiotic administration, 2 of 15 patients had infections, which were treated on an outpatient basis. Of 26 patients with initially delayed treatment, 18 showed clinical inflammatory symptoms with a wide spectrum of pathogens (Escherichia coli, Streptococcus, Enterococcus, Staphylococcus epidermidis, and Proteus) on presentation.


CONCLUSIONS
Extensive animal bite wounds on the face, even with soft tissue defects, should be treated according to the criteria of a esthetic reconstructive facial surgery. In view of the low infection rate, routine antibiotic prophylaxis is not justified.
Wolff
K D
KD
Department of Maxillofacial Plastic Surgery, Free University of Berlin, Benjamin-Franklin Medical Center, Germany.
D000293:Adolescent; D000818:Animals; D019072:Antibiotic Prophylaxis; D001733:Bites and Stings / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000601:surgery; D004285:Dogs; D016983:Enterococcus / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011512:Proteus Infections / Q000188:drug therapy; D012307:Risk Factors; D017695:Soft Tissue Injuries / Q000601:surgery; D013203:Staphylococcal Infections / Q000188:drug therapy; D013212:Staphylococcus epidermidis / Q000187:drug effects; D013290:Streptococcal Infections / Q000188:drug therapy; D014946:Wound Infection / Q000188:drug therapy / Q000517:prevention & control
D010406:Penicillins