Comparative Study of Primary Closure Versus Non-Closure in Dog Bite Wounds

Abstract

Introduction: Dog bites are common in India accounting to 1-2% of patients presenting to Emergency department. There is long drawn controversy regarding the treatment protocol for dog bites. Several studies have shown comparable amount of wound infection in both these techniques with better aesthetic appearance following Primary closure. We conducted a study to compare the rate of infection, aesthetic outcome & the wound healing time between Primary closure and Non-closure technique. Materials & Methods: After Ethical committee clearance,120 consecutive patients with Dog bite wounds were included in this Experimental control trial. The patients were divided into two groups based on computer-based randomization.All dog bite wounds received initial wound care. One group underwent Primary suturing of wound and in other group wounds were dressed without suturing. Prophylactic antibiotics were given to all patients. Human immunoglobulin was administered according to WHO guidelines. Infection rates, cosmetic appearance and healing time were compared. Results: The infection rate in primary closure was 8.3% as compared to 11.7% in Non-closure. However, it was not statistically significant (P=0.543). Primarily closed wounds had 86.7% good scars as compared to 11.7% in Non-closure which was statistically significant (p=0.001). We also found that the Mean healing time was 23.65 days in Primary closure and 49.05 in Non-closure. Conclusion: Primary suturing of dog bite wounds leads to faster healing rate with no significant change in the infection rate & yields a good cosmetic scar. Local infiltration of wound with immunoglobulin showed no change in the rate of infection.