Management of facial dog bite injuries

Failure of Postexposure Treatment of Rabies in Children

“…K. Bhanganada has studied delayed closure of animal-bite injuries in Thailand and has found a lower incidence of infection than when closure is done shortly after injury; delayed closure, after daily dressing of wounds and appropriate antibiotic therapy, carried a lower risk of infection than did primary repair (K. Bhanganada, unpublished data and [16]). The surgical treatment of severe facial dog bites was also recently reviewed by Morgan et al [17]. Though no prospective studies have been done to support this practice, it might be justified in such extreme cases to double the initial vaccine dose in an effort to produce earlier and higher neutralizing antibody titers.…”

Facial bite wounds: management update

“…In the vast majority of cases, however, serious injury can be readily ruled out, and then assessment of the patient should focus on the possible functional and cosmetic consequences of the wound and the likelihood of local or systemic infectious complications 78 . According to GOLDSTEIN 46 , there may be two distinct groups of patients suffering from animal bite wound: those seen within 8-12 h after injury, who are typically concerned about the esthetic consequences of the wound or the need for rabies and tetanus prophylaxis, and those presenting beyond that period, usually with established infection 49 .…”

“…In urban areas, the majority of such wounds are caused by dogs, cats and humans 2,66,96 . Since a large percentage of dog and human bites are located on the face 2,33,96 , the oral and maxillofacial surgeon is frequently involved in the surgical care of these wounds 78,84,99 , but also in therapeutic decisions for bite victims, as an expert in the management of infections caused by the pathogenic oral flora. The present article reviews the characteristics of bite wounds that are of interest to the oral and maxillofacial surgeon, providing guidelines for effective treatment.…”

Mordedura craneofacial por perro

“…En el hocico canino, existen más de 64 especies de bacterias potencialmente patógenas para el ser humano; destacan las aeróbicas como el estreptococo beta hemolítico alfa y beta, estafilococo aureus y epidermidis, Mordedura craneofacial por perro Pasteurella multocida, E. coli y pseudomona; anaeróbicas como B. fragilis y Prevotella y fisobacterium 22 . No obstante que la Norma Oficial Mexicana e inclusive libros de texto de cirugía recomendaron no afrontar las heridas de esta naturaleza 5,23 , el tratamiento integral de las heridas por mordedura de perro en cara y cráneo, incluye limpieza y desbridación del tejido necrótico y se recomienda como lo hacemos nosotros, emplear productos antisépticos yodados. La curación incluye revisión de estructuras anatómicas especiales y la remoción de tejido necrótico.…”

“…Cuando la herida es extensa y profunda 25 , se recomienda utilizar ampicilina con o sin sulbactam asociada a doxicilina o ceftriaxona 23 . Las lesiones traumáticas en niños pequeños son previsibles aplicando criterios primarios de prevención como en las mordeduras por perro.…”