Primary Closure of Mammalian Bites

Abstract

Abstract. Objective: Suturing of bite wounds remains controversial. The authors evaluated the incidence of wound infection in 145 mammalian bite wounds treated with primary closure. Methods: Consecutive patients with bite wounds receiving primary closure at a university hospital ED had structured closed-question data sheets completed at the time of wound management and suture removal. Infection was determined at the time of suture removal using a previously validated definition. Data included demographics; medical history; time from injury to evaluation; wound characteristics and location; details of wound cleansing methods, debridement, foreign body removal, and wound closure methods; use of antibiotics; and follow-up wound evaluation. Proportions and 95% confidence intervals were calculated. Results: One hundred forty-five mammalian bite patients were enrolled: 88 dog, 45 cat, and 12 human bites. Patients had a mean (ϮSD) age of 21 Ϯ 20 years; 58% were male; 86% were white; and they presented a mean (ϮSD) of 1.8 Ϯ 1.2 hours after injury. Bites occurred on the head and neck (57%), upper extremity (36%), and lower extremity (6%). Wounds had a mean length and width of 2.5 cm and 4.8 mm, respectively. Twelve percent involved structures deep to subcutaneous tissue. After primary wound closure, wound infections occurred in eight patients (5.5%; 95% confidence interval = 1.8% to 9.2%). Conclusions: The data suggest that carefully selected mammalian bite wounds can be sutured with approximately a 6% rate of infection. This infection rate may be acceptable in lacerations where cosmesis is a primary concern.

Hand Trauma Pitfalls: A Retrospective Study of Fight Bites

“…The practice of delayed closure can also be very effective. Controversially, a recent report suggests primary closure of selected human bite wounds yields comparable results to the traditional approach [27]. In our unit, primary closure is only ever used if the wounds are occlusive bites, not involving a joint and clinically non-infected.…”

The Karapandzic Flap in Lower Lip Reconstruction

“…However, distant flaps have no muscular element and thus provide no sphincteric control. A prospective cohort study by Chen et al [15] demonstrated that primary closure of bite wounds is associated with higher rates of infection (6 %) as compared with other sutured wounds in the same institution. Illustrated the reconstruction of a lip with an upper arm flap.…”

Arrachement du scrotum par morsure humaine: présentation d’un cas et revue de la littérature

“…Toutes les morsures confondues représentent 1 % des urgences aux États-Unis et au Canada [5,6]. Les morsures d'origine humaine constituent la troisième cause par ordre de fréquence aux États-Unis, après les morsures de chiens et de chats [5][6][7][8][9][10][11][12].…”

“…Elles sont faites en particulier par les adolescents lors des bagarres et par les enfants [2,9]. Les morsures faites par les adultes représentent 30 à 40 % [5,11,12].…”

“…Soixante-dix pour cent des lésions par morsures humaines rapportées en Amérique du Nord sont le fait d'adolescents et d'adultes de moins de 40 ans [5,[10][11][12]. Les hommes sont 2 à 12 fois plus touchés que les femmes [5,9].…”