Abstract
BackgroundDog-bite wounds are a common emergency department (ED) presentation, accounting for approximately 5% of traumatic wounds in the US. However, only 20-50% of patients actually present to the ED for medical attention following a dog-bite wound.MethodsThis was a transverse, retrospective audit of medical records of patients that had presented to the Tembisa Provincial Academic Hospital ED with dog-bite wounds during the 2014 calendar year.ResultsOf the 269 patients that were included in the study, 148 (55%) were male. The median age of all study patients was 27 years (range: 3-77 years). Most patients presented between 18h00-24h00 (n = 111, 41.3%). Most wounds were sustained on the lower limbs (n = 80, 68.18%), followed by the upper limbs (n = 74, 28.03%). Patients who were ≤12 years of age had a higher prevalence of buttock/perineum (p = 0.0002) and head/face/neck (p = 0.009) wounds, whereas patients who were >12 years of age had a higher prevalence of lower limb wounds (p = 0.0006). Only 15 (5.6%) wounds were sutured, and antibiotics were prescribed to 120 (45.1%) patients. Tetanus toxoid vaccine (TTV) and the first dose of the rabies vaccine (RV) were administered to 152 (57.4%) and 240 (89.1%) patients, respectively.ConclusionChildren are more likely to present with wounds to the head/face/neck or buttock/perineum regions, while adults are more likely to present with wounds to the lower limbs. Proper strategies should be implemented to ensure that clinicians adhere to the current antibiotics protocols as well as rabies and tetanus post-exposure prophylaxis (PEP)-prescribing guidelines.
Highlights
Bite wounds are a common emergency department (ED) presentation accounting for approximately 5% of traumatic wounds and representing 0.3-1.1% of all ED presentations in the US [1,2]
Controversies relating to the management of dog-bite wounds include the routine prescription of prophylactic antibiotics and criteria for the suitability of primary wound closure [5]
Based on the estimated population size obtained from recent national census and extrapolation from data from the US, the incidence of dog-bite wounds in South Africa is estimated to be more than 200,000 cases per annum [8,9]
Summary
Bite wounds are a common emergency department (ED) presentation accounting for approximately 5% of traumatic wounds and representing 0.3-1.1% of all ED presentations in the US [1,2]. Only 20-50% of patients present to the ED for medical attention following dog bites in the US [3]. Local data on the presentation and management of dog-bite wounds are limited [6,7]. The management of patients with dog-bite wounds was shown to incur a huge expense at a tertiary level hospital located in the KwaZulu-Natal province of South Africa. Dog-bite wounds are a common emergency department (ED) presentation, accounting for approximately 5% of traumatic wounds in the US. Only 20-50% of patients present to the ED for medical attention following a dog-bite wound
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