Animal Inflicted Maxillofacial Injuries: Treatment Modalities and Our Experience
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Animal inflicted injuries to the face and neck are becoming much more common as people lavish affection on pets. Injuries caused by animal attacks to the face can cause complex injuries to soft and hard tissues, presented as perforations, lacerations, crushes, avulsion or fractures. An uncountable number of bacteria and virus can be found in such injuries, with a potential pathological effect to humans, regarding infections. Although the infection rate is low due to excellent blood supply to face, the injuries have disfiguring effect with possible psychological repercussion to the patients. The treatment of animal inflicted injuries must address the soft tissue defect, neurovascular injuries, and bone injuries as well as prevention of post treatment infection. Primary wound repair is the treatment of choice for most clinically uninfected bite wound where as delayed closure should be reserved for wounds at high risk of infection or already infected wounds and tissue defect may require local flap or micro-vascular re-implantations.
Material and Methods
In this article, we have elicited up to date considerations regarding the management of animal inflicted injuries to the face based on literature search and exemplified by multiple case reports.
For bite injuries on face, immediate primary wound repair after meticulous wound debridement and irrigation with sufficient volume added by antibiotic prophylaxis gives good cosmetic results with minimum risk of infection. Depending upon type of attack and age of victims, psychiatric or social counseling may also be required.
KeywordsAnimal inflicted injuries Wound debridement Primary repair Rabies prophylaxis Psychiatric consultation
Compliance with Ethical Standrds
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Centers for Disease Control and Prevention (CDC) (2003) Nonfatal dog bite-related injuries treated in hospital emergency departments—United States, 2001. MMWR Morb Mortal Wkly Rep 52:605–610Google Scholar
- 4.Pinsolie J, Phan E, Coustal B et al (1993) Dog bites on the face: apropos of 200 cases. Ann Chir Plast Esthet 38:452Google Scholar
- 5.Callabam M (1988) Controversies in antibiotic choices for bite wounds. Arm Emerg Med 17:1321Google Scholar
- 15.Centers for Disease Control and Prevention (CDC) (1997) Dog-bite related fatalities—United States, 1995–1996. MMWR Morb Mortal Wkly Rep 46:463–467Google Scholar
- 16.Weber EJ, Callaham ML (2002) Mammalian bites. In: Marx JA, Hockberger RS, Walls RM (eds) Rosen’s emergency medicine: concepts and clinical practice, 5th edn. Mosby, St Louis, pp 774–785Google Scholar
- 17.Goldstein EJC (2005) Bites. In: Mandell GL, Bennett JE, Dolin R (eds) Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 6th edn. Elsevier Churchill Livingstone, Philadelphia, pp 3552–3556Google Scholar
- 19.Centers for Disease Control (1991) Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures: recommendations of the immunization practices advisory committe (ACIP). MMWR 40(RR-10):1–28Google Scholar
- 25.Medeiros I, Saconato H (2001) Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev 2:CD001738Google Scholar
- 27.Goldstein EJC, Citron DM, Merriam CV, Warren YA, Tyrrell KL, Fernandez HT (2002) Comparative in vitro activity of faropenem and 11 other antimicrobial agents against 405 aerobic and anaerobic pathogens isolated from skin and soft tissue infections from animal and human bites. J Antimicrob Chemother 50:411–420CrossRefPubMedGoogle Scholar
- 30.Keogh S, Callaham ML (2001) Bites and injuries inflicted by domestic animals. In: Auerbach PS (ed) Wilderness Medicine, 4th edn. Mosby, St Louis, pp 961–978Google Scholar
- 31.Lieblich SE, Topazian RG (1997) Infection in the patient with maxillofacial trauma. In: Fonseca RJ, Walker RV (eds) Oral and maxillofacial trauma, 2nd edn. Philadelphia, WB Saunders, pp 1248–1273Google Scholar
- 35.Trott AT (1997) Wound cleansing and irrigation. In: Trott AT (ed) Wounds and lacerations: emergency care and closure, 2nd edn. Mosby, St Louis, pp 90–101Google Scholar
- 41.Murakami CS, Nishioka GJ (1996) Essential concepts in the design of local skin flaps. Facial Plast Surg Clin N Am 4:455–468Google Scholar
- 42.Papel I (2002) Facial plastic and reconstructive surgery, 2nd edn. Thieme Medical Publishers, New YorkGoogle Scholar
- 43.Baker SR (1994) Local cutaneous flaps. Otolaryngol Clin North 27:139Google Scholar
- 45.Arndt KA, Leboit O, Robinson J et al (1996) Cutaneous medicine and surgery. WB Saunders, PhiladelphiaGoogle Scholar