Postoperative Wound Infection After Primary Closure in Pediatric Dog Bite Injuries

Area of Science:

• Pediatric Trauma Surgery
• Infectious Disease Management
• Wound Care Protocols

Background:

• Current guidelines suggest 3-5 days of antibiotic prophylaxis for dog bite injuries.
• Clinical practice varies, especially after primary wound closure.
• An institutional protocol was implemented to limit post-repair antibiotics to a maximum of 3 days.

Purpose of the Study:

• To analyze the impact of a new protocol on antibiotic duration for pediatric dog bite wounds.
• To determine the incidence of wound infection following primary closure under the new protocol.
• To assess the safety and feasibility of standardized, shorter antibiotic durations.

Main Methods:

• Retrospective review of pediatric dog bite injuries (≤18 years) undergoing primary closure (2018-2022).
• Data collection included demographics, clinical details, and antibiotic duration.
• Multivariable regression analysis was used to identify factors associated with wound infection.

Main Results:

• The mean antibiotic duration decreased from 6.8 to 4.4 days post-protocol implementation (P < 0.001).
• Shorter antibiotic duration (≤3 days) was not associated with an increased risk of wound infection.
• The postoperative wound infection rate was similar between short-course and long-course antibiotic groups (7.5% vs. 7.1%, P = 0.912).

Conclusions:

• Standardizing postoperative antibiotic duration to a maximum of 3 days for pediatric dog bite wounds is feasible.
• This standardization effectively reduces antibiotic exposure without compromising patient safety or increasing infection rates.
• The study supports multidisciplinary efforts to optimize pediatric trauma care and antibiotic stewardship.