Infection prevention and treatment following dog bites: a systematic review of randomized controlled trials

Dog bites pose a significant global public health challenge, with outcomes that range from minor injuries to fatalities. Despite their prevalence, no consensus has been established regarding the most effective prevention and treatment strategies. This systematic review aimed to consolidate and evaluate randomized controlled trials (RCTs) examining the effectiveness of interventions in preventing and treating dog bites.

A comprehensive search was conducted across the CINAHL, Embase, MEDLINE, Web of Science, and PubMed databases for RCTs published within the last 10 years. Studies were included if they focused on interventions to prevent or treat dog bites. Primary outcomes included the infection rate and recovery time of dog bites, the effectiveness of interventions in preventing or reducing bite severity, and associated health outcomes. The risk of bias was assessed using the Cochrane Collaboration tool.

Five RCTs met the eligibility criteria, with a total of 1,148 participants. These studies examined various interventions, including medical techniques (medical glue, negative pressure wound therapy, and hyperbaric oxygen therapy), wound management strategies (primary suturing versus non-suturing), and educational interventions. A meta-analysis of four studies revealed no significant difference in infection rates between the intervention and control groups (risk ratio, 0.69; 95% confidence interval [CI], 0.27-1.77; I2=62%; P=0.44). However, the interventions examined in each study demonstrated shorter recovery times (mean difference, 11.25 days; 95% CI, 8.44-14.07 days; I2=99%; P<0.001).

Although the included studies suggest potential benefits of certain interventions in treating dog bites, particularly in reducing recovery time, the evidence regarding infection prevention remains inconclusive. The limited number of high-quality RCTs in this field highlights the need for further research to establish evidence-based guidelines for dog bite prevention and treatment.