Mammalian Bites: ED presentations, evaluation, and management

Strongest evidence for antibiotic prophylaxis are for bites to the hand. There is also some evidence that suggests using prophylactic antibiotics for clinically significant human bites. There is not strong evidence, however, supporting prophylaxis in bites from domestic animals that do not involve the distal extremities

Fight Bite

All patients with fight bite injuries need: Consult for wound exploration and OR for washout and debridement, Antibiotics covering human oral flora (Streptococcus sp., Staphylococcus sp., Eikenella sp., and anaerobes): Unasyn (ampicillin/sulbactam) IV followed by Augmentin (amoxicillin+clavulanate) PO, Third generation cephalosporin + flagyl or clindamycin IV followed by trimethoprim-sulfamethoxazole OR cefuroxime(2nd gen cephalosporin) PLUS clindamycin

Animal and Human Bites: When Stitches Are Needed

Most dog bites can be stitched, especially if the wound is large. In general, cat bites are not stitched. Cat bites are usually puncture wounds and can be quite deep. Cat bites have a higher risk of infection than dog bites. Human bites are not usually stitched unless they are on the face or ear. Human bites have a high risk of infection. Most facial bites can be safely stitched. The risk of infection to the face is lower because the face normally has good blood flow. Because of good blood flow, a face wound may heal faster if it is stitched as soon as possible after a bite. Bites to the hand or foot, whether from an animal or a human, are generally not stitched. These bites carry a high risk of infection, and stitching the wound further increases the likelihood of infection. In some situations, a dog bite to the hand may be stitched.

Bark for Dogmentin: Bite injuries

Human bites are special…. and gross. Human bite injuries are not-so-much a true bite, but more of a fist-meets-mouth injury. Clenched fist injuries, known as “fight bites”, result in a closed fist meeting teeth. Skin can be broken, resulting in the inoculation of a wound with human oral flora.

Bite wounds: Don’t let patients leave with a wrong impression

A recheck of the wound within 24 hours should be arranged. If, however, signs of moderate to severe infection are present, the patient should be referred to a hand specialist and admitted.

Fight bite injuries

All human bite wounds are potentially serious and at risk of catastrophic complications. But the particular type called fight bite is very common and often treated as minor injury, because underestimation of the lesion without the recognition that the joint capsule, extensor tendon or deep fascial may be damaged and contaminated with oral bacteria.

Human and Other Mammalian Bite Injuries of the Hand: Evaluation and Management

The hand is the most common site for bite injuries. Because of specific characteristics of hand anatomy, bite mechanics, and organisms found in human and animal saliva, even small wounds can lead to aggressive infections.

Human Bite Wounds: A Swiss Emergency Department Experience

Human Bite Wounds: A Swiss Emergency Department Experience Human bites (HB) are the third most common bite wound diagnosed in emergency departments, after dog and cat bites. Management of HB can be challenging, given the high risk of infection associated with multiorganism-rich oral flora.

Human Bites in Adults: A Descriptive Analysis

Human bites were potentially dangerous wounds and constituted a significant cause of morbidity.

Managing human bites

Human bites are frequently overlooked in making a diagnosis in the emergency room. They are particularly notorious due to the polymicrobial nature of human saliva inoculated in the wound and the risk they pose for transmission of infectious diseases. Early treatment, appropriate prophylaxis and surgical evaluation are the key to achieving desired treatment outcomes

The Fight Bite

Human bite wounds are a common source of polymicrobial infections accounting for many emergency room visits. One bacteria, Eikenella corrodens, has been implicated in a specific type of wound to the hand called the 'fight bite' or 'clenched fist' injury.