A review of 48 patients after bear attacks in Central India: Demographics, management and outcomes

ABSTRACT

Introduction: Bear attacks though relatively rare are frequent enough to be of concern for those who are in bear habitats. Our centre at Nagpur, being surrounded by dense forests from all the sides, treats a large number of victims. Aim: The aim was to document the injuries, management and the potential complications of bear attacks. Materials and Methods: We reviewed the records of 48 consecutive patients who were treated in our department from January 2006 to December 2013 for bear attacks. Outcome: The majority of patients were referred 24-48 h post-attack. All but two patients had involvement of either the face or scalp. Involvement of eyes, mandible, facial nerve, was common. Reconstruction included simple suture of lacerations to management of complex compound injuries with three-dimensional defects. Thirteen patients developed infection. Conclusion: Bear attack victims need a multidisciplinary approach. Early broad spectrum antibiotics, anti-rabies prophylaxis and irrigation and debridement of the wound are needed. We advise early referral to tertiary treatment centres.

KEY WORDS

Bear mauling - complications - reconstruction - sloth bear

 

Conflicts of interest

None declared.

• REFERENCES

• 1 Sudarshan MK, Mahendra BJ, Madhusudana SN, Ashwoath Narayana DH, Rahman A, Rao NS. et al. An epidemiological study of animal bites in India: Results of a WHO sponsored national multi-centric rabies survey. J Commun Dis 2006; 38: 32-9
• 2 Kale S, Patil S, Khare N, Jain A. Animal bites-should primary reconstruction be the standard treatment?. Euro J Plast Surgery 2011; 34: 367-73
• 3 Wikipedia: Sloth bear. Available from: http://www.en.wikipedia.org/Sloth_bear last accessed on 18/12/2014 at 19:38 hrs.
• 4 Wikipedia: Bear attack. Available from: http://www.en.wikipedia.org/wiki/Bear_attack last accessed on 18/12/2014 at 19:40 hrs.
• 5 Shah AA, Mir BA, Ahmad I, Latoo S, Ali A, Shah BA. Pattern of bear maul maxillofacial injuries in Kashmir. Natl J Maxillofac Surg 2010; 1: 96-101
• 6 Frank RC, Mahabir RC, Magi E, Lindsay RL, de Haas W. Bear maulings treated in Calgary, Alberta: Their management and sequelae. Can J Plast Surg 2006; 14: 158-62
• 7 Herrero S. Human injury inflicted by grizzly bears. Science 1970; 170: 593-8
• 8 Venkataswamy G, Rajagopalan AV. A case of injury of right eye by a bear. J All India Ophthalmol Soc 1962; 10: 22-3
• 9 Prasad SC, Thada ND, Rao P, Thada SR, Prasad KC. Grievous temporal and occipital injury caused by a bear attack. Case Rep Otolaryngol 2013; 2013: 957251
• 10 Jethani J, Nagori R, Ghodadara B. An unusual case of bear bite with severe loss of tissue. Indian J Ophthalmol 2006; 54: 287-8
• 11 Ram R. Maxillofacial Injuries due to Bear Mauling. J Maxillofac Oral Surg 2011; 10: 85-9
• 12 Roka YB, Roka N, Shrestha M, Puri PR, Adhikari HB. Penetrating head injury with bilateral eye avulsion due to Himalayan bear bite. Emerg Med Australas 2012; 24: 677-9