title: Mammalian bite injuries to the head and neck region.
abstract: OBJECTIVE
  To determine the frequency and presentation of mammalian bite injuries to the head and neck region seen in a plastic surgery unit.
  
  
  METHODS
  Observational study. PATIENTS AND DURATION OF STUDY: The Plastic and Reconstructive Surgery Unit, PGMI, HMC, Peshawar from July 1999 to June 2003.
  
  
  METHODS
  During the study period 40 patients presented with mammalian bite injuries to the head and neck region. Information about patient's demographics, biting animal, circumstances of sustaining injury, duration of injury, location and extent of injury, treatment administered, cosmetic outcome and complications were noted.
  
  
  RESULTS
  The mammalian bite injuries accounted for 10% of patients managed within the study period for soft tissue injuries to the orofacial region. Among the 40 cases studied, 3 patients were females and 37 were males. Age ranged from 2.5 years to 71 years with the mean of 23 years. The duration of injury varied from 1 hour to 1 year (median 3+2 days). Mammals implicated were humans, dogs, horse, donkey, bear and wolf. All of the 40 patients presented with head and neck injury. Auricular injury was seen in 10 patients, lip injuries in 10 patients, nasal injuries in 10 patients, cheek injuries in 6 patients and scalp injuries in 4 patients. In 70% (28) of cases avulsion of tissue (type-III) was noted. Patients presenting earlier for treatment achieved better cosmesis than the patients presenting late in the course of their injury.
  
  
  CONCLUSIONS
  Mammalian bite injuries to the head and neck region can result in facial disfigurement with distressing physical and psychological consequences. Early management of such complex injuries usually guarantees satisfactory outcome.
authors.affiliation: Department of Plastic Surgery, PGMI, Hayatabad Medical Complex, Peshawar, Pakistan.
authors.forename: Fahim
authors.initials: F
authors.lastname: Ullah
authors.forename: Mohammad
authors.initials: M
authors.lastname: Tahir
authors.lastname: Masoodurehman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aslam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology*; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D004285:Dogs; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008322:Mammals; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology*; D010154:Pakistan / Q000453:epidemiology; D017695:Soft Tissue Injuries / Q000453:epidemiology