How To Treat Bite Injuries

By Tamara D. Fishman, DPM

As the warmer months emerge, people are more likely to tackle spring cleaning of cluttered areas, go outside without shoes and socks, and head to the beach for fun in the sun. Unfortunately, there is also an increased risk of lower-extremity bite injuries with these scenarios, whether the injuries are from dogs, insects, spiders or stingrays.
Let’s start out by taking a closer look at dog bite injuries. Every 40 seconds, someone in the United States seeks medical attention for a dog bite-related injury, according to the Centers for Disease Control and Prevention (CDC). From 1979 to 1998, dog attacks killed more than 300 Americans.
There is a dog bite epidemic in the United States. In a 10-year period, the number of dogs rose by 2 percent while the number of bites increased by 37 percent. There are almost 5 million victims annually and 800,000 of these people need medical attention.

Children are at greater risk of injury and death from dog bites. In 1994, approximately 2.5 percent of U.S. children under 14 years old were bitten compared with 1.6 percent of adults over the age of 18. In 1997 and 1998, 27 people died from dog bites and 19 of them were children under 12. Children, especially boys ages 5 to 9, have the highest incidence rate for emergency department visits resulting from dog bites.
When it comes to breeds that pose a high risk for dog bite injuries, the CDC says to be wary of pitbulls, rotweilers, German shepherds, huskies, Alaskan malamutes, Doberman pinschers, chows, Great Danes, St. Bernards and akitas.
Dog bites can cause puncture wounds, lacerations and crush injuries. Dog bites may contain Pasteurella multocida, mixed anaerobes and staphylococcus.
Cat bites are often puncture wounds that may contain Pasteurella multocida. Other aerobes and anaerobes include S. aureus.
Bite wound treatment consists of:
• obtaining a complete medical history (including any first aid that was performed);
• administering appropriate tetanus prophylaxis;
• performing appropriate wound care;
• splinting lacerated legs;
• elevating the extremity; and
• administering prophylactic antibiotics if the animal’s teeth penetrated to bone or tendon sheath or if the wound is more than eight hours old.
Amoxicillin/clavulanate covers most of the organisms found in dog and cat bite wounds. You may administer tetracycline as an alternative to augmentin. Overall, it’s important to clean wounds well, administer antibiotics if necessary and follow these patients closely.

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