title: A review of 48 patients after bear attacks in Central India: Demographics, management and outcomes.
abstract: BACKGROUND
  Bear attacks though relatively rare are frequent enough to be of concern for those who are in bear habitats. Our centre at Nagpur, being surrounded by dense forests from all the sides, treats a large number of victims.
  
  
  OBJECTIVE
  The aim was to document the injuries, management and the potential complications of bear attacks.
  
  
  METHODS
  We reviewed the records of 48 consecutive patients who were treated in our department from January 2006 to December 2013 for bear attacks.
  
  
  RESULTS
  The majority of patients were referred 24-48 h post-attack. All but two patients had involvement of either the face or scalp. Involvement of eyes, mandible, facial nerve, was common. Reconstruction included simple suture of lacerations to management of complex compound injuries with three-dimensional defects. Thirteen patients developed infection.
  
  
  CONCLUSIONS
  Bear attack victims need a multidisciplinary approach. Early broad spectrum antibiotics, anti-rabies prophylaxis and irrigation and debridement of the wound are needed. We advise early referral to tertiary treatment centres.
authors.affiliation: Department of Plastic surgery, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Surendra B
authors.initials: SB
authors.lastname: Patil
authors.affiliation: Department of Plastic surgery, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Nikunj B
authors.initials: NB
authors.lastname: Mody
authors.affiliation: Department of Plastic surgery, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Satish M
authors.initials: SM
authors.lastname: Kale
authors.affiliation: Department of Plastic surgery, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Sonali D
authors.initials: SD
authors.lastname: Ingole
keywords: Bear mauling; complications; reconstruction; sloth bear