Animal Bite Injuries to the Face: A Retrospective Evaluation of 111 Cases
Michael Maurer,
Cornelius Schlipköter,
Maximilian Gottsauner
et al.
Abstract:The treatment of bite wounds to the face is discussed controversially in relation to surgery and antibiotics. The aim of this study is a retrospective evaluation of 111 cases of animal bite injuries to the face that presented to our unit of oral and maxillofacial surgery over a 13-year period. Children under 10 years of age were predominantly involved. A total of 94.5% of the assessed injuries were caused by dogs. Wound infections occurred in 8.1%. Lackmann type II was the most common type of injury (36.9%). T… Show more
“…The literature indicates that bear attacks are topically different from attacks by other wild animals in that the face is the most common target [ 12 ]. This is consistent with the findings of Maurer M. et al (2023), who noted the prevalence of trauma to parts of the face, such as the perioral and periorbital regions, ears, and nose [ 21 ].…”
Section: Discussionsupporting
confidence: 92%
“…Because of a bear attack, a person will receive multiple injuries, necessarily including the head [ 10 , 11 , 17 , 18 , 19 , 20 , 21 ]. The cranio-maxillofacial region is the most common and vulnerable site affected during a bear attack [ 12 ].…”
Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. Such injuries are frequent in Siberia, which is a territory surrounded by dense forests inhabited by brown bears. In the last 4 months alone (September–December 2023), four bear attacks on humans were registered in Khakassia, Russia. This article presents a clinical case of rehabilitating a patient after a bear attack, who suffered multiple fragmentary fractures of the facial skeleton with displaced bone fragments, subcutaneous emphysema of the soft tissues of the face, damage to the parietal and right occipital regions and paranasal sinus hemorrhage on the left side. The nature of the injuries was enhanced by trauma to the upper extremity caused by the patient defending himself against the animal. In addition to the damage to his face, the bear tried to open his cranium, as evidenced by four furrows caused by its canines, including two each on the frontal and occipital bones of the skull. The patient’s complex treatment included both maxillofacial and reconstructive surgeries, and outpatient treatment involved the formation of normotrophic scars using a neodymium laser and injections of a heterogeneous composition consisting of microparticles of “crosslinked” collagen of animal origin placed in a gel identical to the natural extracellular matrix.
“…The literature indicates that bear attacks are topically different from attacks by other wild animals in that the face is the most common target [ 12 ]. This is consistent with the findings of Maurer M. et al (2023), who noted the prevalence of trauma to parts of the face, such as the perioral and periorbital regions, ears, and nose [ 21 ].…”
Section: Discussionsupporting
confidence: 92%
“…Because of a bear attack, a person will receive multiple injuries, necessarily including the head [ 10 , 11 , 17 , 18 , 19 , 20 , 21 ]. The cranio-maxillofacial region is the most common and vulnerable site affected during a bear attack [ 12 ].…”
Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. Such injuries are frequent in Siberia, which is a territory surrounded by dense forests inhabited by brown bears. In the last 4 months alone (September–December 2023), four bear attacks on humans were registered in Khakassia, Russia. This article presents a clinical case of rehabilitating a patient after a bear attack, who suffered multiple fragmentary fractures of the facial skeleton with displaced bone fragments, subcutaneous emphysema of the soft tissues of the face, damage to the parietal and right occipital regions and paranasal sinus hemorrhage on the left side. The nature of the injuries was enhanced by trauma to the upper extremity caused by the patient defending himself against the animal. In addition to the damage to his face, the bear tried to open his cranium, as evidenced by four furrows caused by its canines, including two each on the frontal and occipital bones of the skull. The patient’s complex treatment included both maxillofacial and reconstructive surgeries, and outpatient treatment involved the formation of normotrophic scars using a neodymium laser and injections of a heterogeneous composition consisting of microparticles of “crosslinked” collagen of animal origin placed in a gel identical to the natural extracellular matrix.
“…The literature indicates that bear attacks are topically different from attacks by other wild animals in that the face is the most common target [12]. This is consistent with the findings of Maurer M. et al (2023), who noted the prevalence of trauma to parts of the face, such as the perioral and periorbital regions, ears, and nose [21].…”
Section: Discussionsupporting
confidence: 81%
“…Because of a bear attack, a person will receive multiple injuries, necessarily including the head [10,11,[17][18][19][20][21]. The cranio-maxillofacial region is the most common and vulnerable site affected during a bear attack [12].…”
Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. The frequency of such injuries is high in Siberia, which is a territory surrounded by dense forests and is a habitat of brown bears. Only for the last 4 months (September - December) 4 episodes of bear attacks on humans were registered in Khakassia, Russia. We present a clinical case of rehabilitating a patient after a bear attack for multiple fragmentary fracture of the facial skeleton with displacement of bone fragments, subcutaneous emphysema of soft tissues of the face, parietal and right occipital regions, and paranasal sinus hemorrhage on the left side. The nature of the injury was enhanced by the trauma to the upper extremity, with which the patient defended himself against the animal. In addition to the damage to the face, the bear tried to open the cranium, which was evidenced by 4 furrows from the canines, 2 on the frontal and 2 on the occipital bones of the skull. The complex treatment of the patient included both maxillofacial and reconstructive surgery, and at the stage of outpatient treatment the formation of normotrophic scars with the help of neodymium laser and injections of heterogeneous composition consisting of micro-particles of "cross-linked" collagen of animal origin, placed in a gel identical to the natural extracellular matrix.
ZusammenfassungBissverletzungen stellen wegen des tief inokulierten polymikrobiellen Erregerspektrums, möglicher Begleitverletzungen und ausgeprägter Weichteilschäden ein differenziert zu behandelndes Krankheitsbild dar. Hundebisse sind die häufigsten Bissverletzungen und heilen, verglichen mit Menschen- und Katzenbissen, weniger komplikativ. Die Bisslokalisation hängt stark vom Alter und von der Größe des Bissopfers sowie der Art des Bissverursachers ab. Bei jedem Biss ist der Erregernachweis anzustreben, um auf eine Exazerbation kalkuliert reagieren zu können. Die primäre Antibiotikatherapie sollte empirisch mit Amoxicillin + Clavulansäure oder Ampicillin + Sulbactam erfolgen und ggf. im Verlauf antibiogrammgemäß angepasst werden. Die chirurgische Sanierung beinhaltet je nach Befund das Ausschneiden des Bisskanals und das differenzierte Wund-Débridement. Wichtig sind die Überprüfung des Impfstatus der Beteiligten und, wenn indiziert, die Postexpositionsprophylaxe für Tetanus und Tollwut.
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