Animal bites—should primary reconstruction be the standard treatment?

Abstract

We present a series of 91 cases caused by both wild and domestic animals over a period of 5 years from 2005–2009. The objective of the study was to compare the results of primary reconstruction with the traditional method of debridement and secondary healing. A total of 91 patients were studied from January 2005–December 2009. In 54 patients, the injuries were carefully documented, and immediate reconstruction was performed. Thirty-seven patients with contraindications to surgery or who refused to undergo surgery were allowed to heal by secondary intention and were studied as a control group. The patients and their relatives were asked to rate their result and outcome. Among the 54 patients who underwent primary reconstruction, 37 patients were males and 17 were females. Age ranged from 2 to 70 years. Amongst the wild animals, bear was the most common offending animal while dog was the most common street animal. Overall bear bites were the most common presentation to our facility. Four out of 54 cases (7.4%) with primary reconstruction developed infection of the operative site. Of the patients with immediate reconstruction, 57.4% thought that the result was excellent, 35.2% patients were satisfied with the result but wanted further refinement while 7.4% were unhappy and wanted immediate revision. Of the 37 patients who did not undergo primary reconstruction, 16.2% thought that the result was excellent, 45.9% were satisfied and 37.8% wanted immediate revision. We recommend that animal bite wounds should be considered for reconstruction at the earliest to achieve maximal functional and aesthetic results.