Retrospective evaluation of the diagnosis and management of dog bite injuries in the head and neck area

Introduction:

Animal bite injuries are common events, mostly caused by dogs. The epidemiological data for Germany are incomplete due to the high number of unreported cases. In the head and neck region mostly affected areas are nose, cheeks and lips. Patients suffer from mutilating injuries or disfiguring scarring.

Methods:

For this descriptive retrospective study, we reviewed the management of patients with dog bite injuries in the head and neck region at the ENT department of Ulm University hospital between 2012 and 2018. Clinical data were obtained from patient records and analyzed with respect to patients age, required surgical interventions and associated infectious complications.

Results:

41 patients from 9 months to 63 years (mean age 19 years) were included. In> 80% (n = 33) patients suffered from facial injury of severity I-II according to Lackmann. In 78% surgical wound care/exploration was required. Almost all patients (n = 38) were treated with a beta-lactam antibiotic (cefuroxime/augmentan/unacid). In 22% (n = 9) local inflammatory complication occurred, microbiological examination revealed a polymicrobial flora typical of the dog saliva in three cases.

Conclusion:

Patients with dog bite injuries in the head and neck area, were usually younger than 20 years old and had in the majority of cases an injury severity I-II according to Lackmann. Cephalosporins and aminopenicillins are suitable for the phrophylactic and therapeutic use, pathogen detection seems to be not necessary from a priori uninfected wounds. The generous use of a systemic antibiotic treatment has to be discussed.

Publication History

Publication Date:
23 April 2019 (online)