title: Primary repair of facial dog bite injuries in children.
abstract: OBJECTIVE
  The management of dog bite wounds is controversial, and current data on risk of infection are variable and inconsistent. Furthermore, the use of prophylactic or empiric antibiotics for the treatment of these wounds is debatable. We investigate the rate of wound infections and other complications after primary repair of pediatric facial dog bite injuries.
  
  
  METHODS
  We reviewed 87 consecutive patients aged 18 years or younger who had facial dog bite injuries from January 2003 to December 2008. Variables examined were age, sex, setting of repair, number of sutures used for repair, whether surgical drains were used, and antibiotic administration. End points measured were incidence of wound infection, need for scar revision, and any wound complications.
  
  
  RESULTS
  The mean age of patients was 6.8 years, and the majority were women (53%). All facial injuries were primarily repaired at the time of presentation either in the emergency department (ED; 46%), operating room (OR; 51%), or an outpatient setting (3%). All patients received an antibiotic course, none of the patients developed wound infection, and no subsequent scar revisions were performed. Three patients repaired in the OR underwent placement of a total of 4 closed-suction drains. The mean (SD) age of patients repaired in the OR was significantly younger than those repaired in the ED (5.7 [3.9] vs 8.0 [4.5] years, respectively; P < 0.01). The number of sutures used were greater for patients repaired in the OR than in the ED (66.4 [39.6] vs 21.7 [12.5], respectively; P < 0.01).
  
  
  CONCLUSIONS
  Intuitively, younger patients and patients with greater severity injuries are more likely to undergo repair in the OR, and this was supported by our data. Overall, we found that primary repair of pediatric facial dog bite injuries, including complex soft-tissue injuries, is safe when performed in conjunction with antibiotic administration; however, further cross-specialty studies are needed to fully characterize these end points in a larger population.
authors: Department of Surgery, Baystate Medical Center, Springfield, MA, USA.
authors: Peter S
authors: PS
authors: Wu
authors: Alana
authors: A
authors: Beres
authors: David B
authors: DB
authors: Tashjian
authors: Kevin P
authors: KP
authors: Moriarty
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000818:Animals; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D001733:Bites and Stings / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D004285:Dogs; D004322:Drainage / Q000706:statistics & numerical data; D004630:Emergencies; D005151:Facial Injuries / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009873:Operating Rooms / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013536:Suture Techniques / Q000706:statistics & numerical data; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D014946:Wound Infection / Q000453:epidemiology / Q000517:prevention & control*