Facial injuries caused by animals in northern Nigeria

We did a retrospective survey of 34 patients who sustained facial injuries after animal associated incidents and presented to three Nigerian teaching hospitals. There were 27 male (79%) and 7 female patients, whose ages ranged from 6 to 40 years. Sixteen (47%) were less than 15 years. Cows (n=14), camels (n=9), and donkeys (n=6) were the most commonly involved. Three dog bites were seen. Knocks from cows' horns (n=9) were the predominant mechanism of injury, followed by falls (n=8) and kicks (n=7). There were many facial lacerations and fractures, and the cheek (n=14), forehead (n=13), and chin (n=10) were the most common sites of soft tissue injury. All injuries were considered to be contaminated irrespective of the duration of the injury. Treatment consisted of thorough debridement and irrigation, primary closure where feasible, and secondary reconstruction in others. All patients were given prophylactic broad-spectrum antibiotics. Overall, outcome was satisfactory except for a few cases of scar formation, facial nerve palsy, and partial laryngeal stenosis. Associated injuries were recorded in nine cases (27%), with rupture of the globe in three patients (9%). One patient died of associated abdominal injuries after being trampled by a herd of cattle. There is a need for adequate protective measures to forstall animal-related incidents that could result in severe facial and other injuries.