title: Management of bite wounds in children and adults-an analysis of over 5000 cases at a level I trauma centre.
abstract: BACKGROUND
  Bite wounds are among the commonest types of trauma to which man is the subject. They account for 5 % of the total traumatic wounds evaluated in the emergency department (ED) and approximately 1 % of all the ED visits. Early estimation of infection risk, adequate antibiotic therapy and if indicated surgical treatment are the cornerstones of successful cure of bite wounds.
  
  
  METHODS
  A total of 5248 consecutive trauma patients were collected prospectively and analysed retrospectively over a period of 15 years in this study at a level I trauma centre, Department of Trauma Surgery, Medical University of Vienna, Austria.
  
  
  RESULTS
  The mean age was 33.8 years (range 0-97), 2620 (49.9 %) were male and 2628 (50.1 %) were female individuals. In our study population, a total of 2530 dog bites (48.2 %), 930 cat bites (17.8 %), 357 other animal bites (6.8 %), 426 human bites (8.1 %) and 1005 human self-bites (19.2 %) have been observed. A total of 995 wounds (19.0 %) have been infected. Surgery was done in 132 wounds (2.5 %).
  
  
  CONCLUSIONS
  We could show a six times higher infection rate of cat bites compared to dog bites. Human bites showed a total infection rate of 8.2 %. Observed infection rate of puncture wounds and wounds greater than 3 cm was 1.5 times higher than for all other wounds in the present study. Total infection rates within 24 h to antibiotic administration was 29.3 %, compared to 65.0 % < 48 h and 81.1 % < 72 h. Time interval also influenced the overall outcome showing a 2.6 increase in acceptable and 1.3 increase in poor outcome after 72 h.
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Manuela
authors.initials: M
authors.lastname: Jaindl
authors.affiliation: Labors.at, Vienna, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Oberleitner
authors.affiliation: Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Endler
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Christiane
authors.initials: C
authors.lastname: Thallinger
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. florian.kovar@meduniwien.ac.at.
authors.forename: Florian M
authors.initials: FM
authors.lastname: Kovar
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D001317:Austria / Q000453:epidemiology; D001733:Bites and Stings / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D062109:Dermatologic Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000517:prevention & control; D059408:Pain Management / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014193:Trauma Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000706:statistics & numerical data; D014946:Wound Infection / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Adults; Antibiotic therapy; Bite wounds; Children; Infection