Dog-bite lacerations: a controlled trial of primary wound closure

• Published in: Archives of emergency medicine Vol. 5; no. 3; pp. 156 - 161
• Main Authors: Maimaris, C, Quinton, D N
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine 01-09-1988; Blackwell; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Biological and medical sciences; Bites and Stings - therapy; Child; Child, Preschool; Debridement; Dogs; Female; Humans; Injuries of the skin. Diseases of the skin due to physical agents; Male; Medical sciences; Middle Aged; Prospective Studies; Random Allocation; Sutures; Therapeutic Irrigation; Traumas. Diseases due to physical agents; Wound Healing; Wound Infection - complications; Wounds, Penetrating - surgery; Wounds, Penetrating - therapy; Fissipedia; Carnivora; Vertebrata; Skin disease; Mammalia; Surgery; Bite; Suturation; Dog
• ISSN: 0264-4924
• DOI: 10.1136/emj.5.3.156

Dog-bite wounds are often left open because of their reputation for infection if primarily closed. A prospective randomized trial comparing primary closure with leaving the wound open was performed to assess infection and cosmesis. Ninety-six patients with 169 lacerations had thorough surgical debridement and irrigation of their wounds. Ninety-two wounds were sutured and 77 left open. No prophylactic antibiotics were given. A total of 13 wounds developed infection: seven sutured and six unsutured wounds (not statistically significant), giving an overall infection rate of 7.7%. Significantly (P less than 0.01), more wound infections occurred in the hand in both groups compared to the rest of the body, indicating that particular attention should be paid to management of such wounds. It was concluded that dog-bite wounds should receive thorough surgical treatment and can be safely sutured at presentation. Special care should be given to hand wounds.