Primary closure of mammalian bites.
E Chen1, S Hornig, S M Shepherd
1Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
Summary
Suturing mammalian bite wounds resulted in a 5.5% infection rate. This suggests carefully selected bite wounds can be closed primarily, especially when cosmetic outcomes are important.
Area of Science:
- Emergency Medicine
- Wound Care
- Infectious Disease
Background:
- Suturing mammalian bite wounds is a debated practice.
- Primary closure aims to reduce scarring and improve cosmetic results.
Purpose of the Study:
- To evaluate the infection rate in mammalian bite wounds treated with primary closure.
- To determine if primary closure is a safe option for select bite wounds.
Main Methods:
- A prospective study of 145 patients with mammalian bite wounds treated with primary closure.
- Data collected on patient demographics, wound characteristics, treatment, and infection at suture removal.
- Infection rates calculated using proportions and 95% confidence intervals.
Main Results:
- 88 dog, 45 cat, and 12 human bites were analyzed.
- The overall infection rate after primary closure was 5.5% (95% CI: 1.8%–9.2%).
- Bites commonly occurred on the head and neck (57%) and upper extremity (36%).
Conclusions:
- Carefully selected mammalian bite wounds can be sutured with an acceptable infection rate of approximately 6%.
- Primary closure may be a viable option for bite wounds where cosmesis is a significant concern.
