title: Shark attack: review of 86 consecutive cases.
abstract: BACKGROUND
  On average there are approximately 50 confirmed shark attacks worldwide annually. Despite their rarity, such incidents often generate much public and media attention.
  
  
  METHODS
  The injuries of 86 consecutive victims of shark attack were reviewed from 1980 to 1999. Clinical data retrieved from the South African Shark Attack Files, maintained by the Natal Sharks Board, were retrospectively analyzed to determine the nature, treatment, and outcome of injuries.
  
  
  RESULTS
  The majority of victims (n = 68 [81%]) had relatively minor injuries that required simple primary suture. Those patients (n = 16 [19%]) with more extensive limb lacerations longer than 20 cm or with soft-tissue loss of more than one myofascial compartment were associated with higher morbidity and limb loss. In 8 of the 10 fatalities, death occurred as a result of exsanguinating hemorrhage from a limb vascular injury.
  
  
  CONCLUSIONS
  Victims of shark attack usually sustain only minor injuries. In more serious cases, particularly if associated with a major vascular injury, hemorrhage control and early resuscitation are of utmost importance during the initial management if these patients are to survive.
authors.affiliation: Department of Surgery, University of Natal, Private Bag 7, Congela, Durban 4013, South Africa. Jwoolgar@netactive.co.za
authors.forename: J D
authors.initials: JD
authors.lastname: Woolgar
authors.forename: G
authors.initials: G
authors.lastname: Cliff
authors.forename: R
authors.initials: R
authors.lastname: Nair
authors.forename: H
authors.initials: H
authors.lastname: Hafez
authors.forename: J V
authors.initials: JV
authors.lastname: Robbs
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001733:Bites and Stings; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012754:Sharks; D017695:Soft Tissue Injuries; D013019:South Africa