Choice of Primary Repair in Animal Bite Wound: A Novel Management Strategy

Animal bites, primarily from dogs and cats, pose a significant threat, especially to children. Wound infections are common complications caused by bacterial flora in the animal's mouth, making surgical debridement and delayed primary closure the standard treatment. However, recent studies reported no increased infection rates with primary closure compared to delayed closure after adequate debridement, particularly for facial wounds. Primary closure offers better cosmetic and functional outcomes. This study presents a case series to guide decision-making on primary suturing versus leaving wounds exposed. Thirty patients with animal bites underwent surgery, including 23 dog bites and seven cat bites. Eight patients with deep facial lacerations from dog bites received immediate debridement and primary closure with epidermal and subcutaneous sutures. None developed infections, and the cosmetic results were excellent. In contrast, all seven cat bite wounds and nine infected dog bite wounds involved high-risk factors, such as puncture wounds, hand injuries or diabetes. For high-risk wounds, early debridement and leaving the wound open after initial treatment proved effective. Primary repair of facial dog bite injuries, even complex ones, is safe and yields good aesthetic outcomes. For high-risk wounds, leaving them open after debridement is recommended to minimise infection risks.