Primary Repair of Facial Dog Bite Injuries at A Tertiary Centre, Outcome and Review of Literature
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Background: Children are the most vulnerable victim of dog bite injury. Face is a commonly affected site and happens during play. It is a potentially life threatening condition as the wound is severely contaminated with Gram positive and Gram negative microorganisms in the saliva of dog. Because of high contamination rate and chance of severe infection, early attention to be paid for the treatment of that wound by means of antibiotics, wound cleansing and debridement. The opinion regarding repair of facial wound is varied. We describe our experience on primary closure of wound with proper precautions. Materials & methods: It is a prospective and observational study of 83 cases of facial dog (all were street dogs) bite injury during October 2014 to February 2017 (2 years and 5 months). All patients were referred from peripheral hospital and we did primary repair in our hospital in every case with proper precaution irrespective of duration of injury. Results analysis: Total 83 cases were analyzed. Among them 62.65% were male and 37.35% were female patients. Commonly affected age group was 2 years to 5 years (50.60%). Different areas of face were affected like cheek, forehead, ear, eye lid, lip, nose scalp and generalised face. Complication rate after repair was 39.75% and most common complication was wound infection. The secondary procedure like secondary stitches, small Z-plasty, skin grafting and injection of steroid for hypertrophic scar were needed in 22.89% of patients. Conclusion: The primary aim is to restore the facial expression by good closure and cosmetically acceptable scar marks. The key to success is proper debridement, anatomical knowledge of face, good tissue handling, closed follow up and antibiotics coverage. So, primary reconstruction of dog bites is possible with good outcome and should be the method of choice.
Authors and Affiliations
Md. Hadiuzzaman, Rajarshi Kumar, Dipak Ghosh, Kalyani Saha Basu, Sumitra Kumar Biswas
Keywords
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