Is the management of dog bite wounds evidence based? A postal survey and review of the literature.
OBJECTIVE
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 and 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 and 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 and E departments in the UK.
Chaudhry
Mehmood A
MA
Accident and Emergency Department, University Hospitals Coventry and Warwickshire, Coventry CV1 4FH, UK. mchaundry@doctors.org.uk
Macnamara
Aidan F
AF
Clark
Shane
S
D000818:Animals; D004285:Dogs; D001733:Bites and Stings / Q000150:complications / Q000628:therapy; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D019538:Health Care Surveys; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014947:Wounds and Injuries / Q000209:etiology / Q000628:therapy; D006801:Humans