The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon.
BACKGROUND
Human bite injuries are both deceptive and challenging in their presentation and management. They remain a frequent presentation to our unit, most often following late night alcohol fuelled aggression.


OBJECTIVE
To audit the management of these wounds, with particular focus on infective complications and outcomes.


METHODS
A three year retrospective chart review was undertaken on all patients referred to the plastic surgery unit from 1 January 2003 through to 31 December 2005.


RESULTS
A total of 92 patients with 96 human bite wounds were identified. The majority were male (92%). Alcohol consumption was documented in 86% of cases. The majority (70%) occurred over the weekend or on a public holiday. Facial injuries made up 70% of injuries with the remainder being to the upper limb. The ear was the most common target of all facial injuries (65%). Infection was documented in 18 cases (20%), with bite injuries to the upper limb and those presenting late (>12 h) having a higher incidence of infection.


CONCLUSIONS
Human bite wounds present a challenge to any emergency department, given the many issues involved in their management. Underestimation of the complexity and potential sequelae of these wounds will result in a suboptimal outcome for the patient.
Henry
Francis P
FP
Department of Plastic, Reconstructive and Hand Surgery, St James's Hospital, Dublin, Ireland. fhenry@rcsi.ie
Purcell
Elizabeth M
EM
Eadie
Patricia A
PA
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D001734:Bites, Human / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D004423:Ear / Q000293:injuries; D004630:Emergencies; D005151:Facial Injuries / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D009666:Nose / Q000293:injuries; D012189:Retrospective Studies; D014754:Violence; D014946:Wound Infection / Q000209:etiology