Management of Human Bite Wounds in Children: A 9-Year Retrospective Study

Human bites are one of the common traumas among children; however, their treatment remains controversial. This study aimed to explore the treatment of human bite wounds in children.

The clinical data of 792 children with human bites were collected between 2014 and 2022. Based on their treatment methods, the patients were divided into the debridement group, primary closure group, and delayed closure group, and the therapeutic effects were analyzed. Pearson χ 2 test was employed to compare classified variables. We used binary logistic regression to identify the risk factors of wound infection.

In total, 660 children with human bites meeting the inclusion and exclusion criteria were enrolled in this study, with an average age of 8.38 y (2 mo to 17 y). The participants were mainly male (85.2%), and the most common site of injury was the head or neck (81.4%). In total, 111 children (16.8%) developed wound infection, and the infection rate was significantly lower in the delayed closure group than in the primary closure group (12.6% versus 29.0%, P < 0.001), but there was no significant difference between the delayed closure group and the debridement group (12.6% versus 7.6%, P = 0.139). There were 395 children with optimal wound healing. The optimal wound healing rate in the delayed closure group was significantly higher than that in the debridement group (76.4% versus 33.1%, P = 0.733), with no significant difference between the delayed closure group and the primary closure group (76.4% vs 80.8%, P < 0.001). In multivariate logistic regression analysis, advanced age (risk ratio (RR) 1.195 per increasing 1-y interval, 95% confidence interval [CI] 1.090-1.310), suture method (RR 4.375 for primary closure compared to delayed closure, 95% CI 2.173-8.808), and onset-to-treatment time (RR 1.029 for each additional hour, 95% CI 1.010-1.049) were independent predictors of wound infection.

For human bites of children, we recommend delayed closure, which can achieve both a low wound infection rate and satisfactory wound healing.