[Management principles of bite injuries]

Bite injuries are frequent and often underestimated injuries associated with a high risk of infection and complications. Regardless of their cause, all bite wounds are considered contaminated. The hands and face are particularly affected, with hand bite injuries posing a high risk for deep infections and permanent functional impairment due to the complex anatomy. A structured initial assessment including the type of bite, location, depth, age of the wound and signs of infection is essential. Small skin lesions do not exclude severe deep-lying tissue injuries. The cornerstone of primary management is immediate and extensive wound irrigation combined with thorough surgical debridement to reduce the bacterial load. Primary wound closure should generally be avoided; exceptions apply to fresh, well-cleaned facial bite wounds without signs of infection. Antibiotic prophylaxis is indicated in defined high-risk situations but does not replace adequate debridement. In addition, assessment of vaccination status, immobilization, elevation and close clinical follow-up within 24-48 h are essential.