Mammalian bites: Difference between revisions
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==Indications for Primary Closure of Mammalian Bites== | ==Indications for Primary Closure of Mammalian Bites== | ||
# | *Consider closure if all of the following are true: | ||
#Not a face or scalp wound | |||
#Repair can occur within 6hr of injury (time dependent upon individual judgment) | #Repair can occur within 6hr of injury (time dependent upon individual judgment) | ||
#Repair only requires single-layer closure; no devitalized tissue | #Repair only requires single-layer closure; no devitalized tissue | ||
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==High-Risk Wounds== | ==High-Risk Wounds== | ||
#Cat or | #Cat, human, livestock, or monkey bites | ||
#Deep puncture wounds | #Deep puncture wounds | ||
#Hand or foot wounds | #Hand or foot wounds | ||
Revision as of 07:36, 10 April 2012
Background
- 5% of untreated dog bites will become infected (similar to rate of non-bite wounds)
- 80% of untreate cat bites will become nfected
Indications for Primary Closure of Mammalian Bites
- Consider closure if all of the following are true:
- Not a face or scalp wound
- Repair can occur within 6hr of injury (time dependent upon individual judgment)
- Repair only requires single-layer closure; no devitalized tissue
- No underlying fracture
- No systemic immunocompromising conditions
High-Risk Wounds
- Cat, human, livestock, or monkey bites
- Deep puncture wounds
- Hand or foot wounds
- Bites in immunosuppressed patients
Treatment
- Abx
- Consider for high-risk wounds (see above)
- Mamallian bites:
- Amoxicilin-clavulanate 875mg PO BID x 5-7d
- Fish bites:
- Fluoroquinolone (for Vibrio coverage)
- Rabies immune globulin
- Indicated for bites from bats, monkeys, skunks, raccoons, foxes