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Jrsocmed00022 0020
Jrsocmed00022 0020
SUMMARY
Dog bites to the face can be life-threatening if major infection occurs, and traditional management consists of
wound toilet and debridement, with repair only when the possibility of infection has been eliminated. Surgical
opinion is now swinging towards earlier repair. We have analysed retrospectively the outcome of 40 cases that,
irrespective of time delay between injury and presentation, underwent primary repair or reconstruction after wound
toilet, debridement and administration of prophylactic antibiotics.
The victims were 17 males and 23 females with ages ranging from 2 to 76 years (mean 25). Median delay between
the injury and presentation in the emergency department was 60 minutes (range 7 minutes to 5 days). All patients
received surgical treatment within 24 hours of admission, 18 being operated on within 6 hours. 31 had primary
repairs and 9 patients had reconstructive procedures with local skin flaps or skin grafts. Primary healing was
achieved in all but 2 patients, of whom one developed minor wound infection and one had necrosis of a composite
graft.
These results support the view that, for dog bites to the face, primary repair is the method of choice.
0
0-10 11-20
Department of Plastic Surgery, Whiston Hospital, Prescot, Merseyside, UK Age range in years
Correspondence to: Mr M Javaid, Department of Plastic Surgery, Figure 1 Patients' ages (mean age=25 years; range=2-76 years;
414 Addenbrooke's Hospital, Cambridge CB2 2QQ, UK n=40)
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE Volume 91 August 1 998
0'
Lip Nose Ear
Site of injury
Chin Forehead Mukiple
I the end of his scar about which he was unconcerned; 2 had
trap-dooring which needed further revision; and 2 had scar
hypertrophy which was treated with corticosteroid cream
and injections.
DISCUSSION
Dogs' teeth are not very sharp but can exert sufficient
pressure to perforate light sheet metalll. Young children 415
IJOURNAL OF THE ROYAL SOCIETY OF MEDICINE Volume 91 August 1 998
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