Microbiological Characteristics and Surgical Management of Animal-Bite-Related Oral & Maxillofacial Injuries: A Single Center's Experience.

Johannes Spille,Henning Wieker,Dorothee Cäcilia Spille,Juliane Schulz,Hendrik Naujokat,Aydin Gülses,Jörg Wiltfang

doi:10.3390/antibiotics10080998

Johannes Spille, Henning Wieker + Show 5 more

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https://doi.org/10.3390/antibiotics10080998

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Abstract

The objective of the current study is to retrospectively evaluate animal-bite injuries and to gain insight into the epidemiology, accident consequences and treatment concept of these accidents in oral and maxillofacial surgery. Data of patients, who were admitted January 2015 and April 2021, were retrospectively evaluated regarding the patients’ characteristics (age, gender), facial distribution of substance defects/partial amputations, duration of hospitalization, operation treatments and antibiotic treatments. Data of 75 patients were included. Patients were bitten by dogs (n = 69.92%), cats (n = 4) and horses (n = 2). Lower eyelid/cheek complex was the most affected region (n = 37, 32.74%). Most of the patients between 0 and 3 years had to be operated on under general anesthesia (p = 0.011), while most of the adults could be operated on under local anesthesia (p = 0.007). In the age group 0–12 years, 30 patients (68%) were operated on under general anesthesia. Ampicillin/Sulbactam (48%) was the antibiotic most used. Antibiotics were adjusted after wound swabs in case of wound infections or critical wound conditions. This means that resistant antibiotics were stopped, and sensitive antibiotics were used. Structured surgical and antibiotic management of animal-bite wounds in the maxillofacial region is the most important factor for medical care to avoid long-term aesthetic consequences. Public health actions and policies under the leadership of an interdisciplinary committee could improve primary wound management, healing outcome and information status in the general population.

Highlights

Up to 30,000–50,000 injuries are associated with bite injuries every year in Germany, 60–80% resulting from dog-bite injuries [1]
The aim of the current study is to retrospectively evaluate the animal-bite-related maxillofacial injuries, to analyze the relation between the animal-bite injuries and the correspondent treatment management and to support as well as to standardize the current medical treatment methods
Pasteurella species score displays a checklist regarding anatomical and functional classification of the injuries and describes bite injuries as well as facial or trigeminal nerve/salivary duct involvement, loss of tissues, gunshot wound, lachrymal drainage system and retrobulbar hematoma under soft tissue injuries as being complicated [12]. This can pose a challenge in medical care, making them an important public health problem

Summary

Introduction

Up to 30,000–50,000 injuries are associated with bite injuries every year in Germany, 60–80% resulting from dog-bite injuries [1]. Animal bites are not reportable in Germany, which is why there is no precise data on the frequency of bite injuries. After the upper and lower extremities, the face is the most common area for bite injuries [4]. These injuries often appear less serious but can lead to dangerous infections with tissue loss or even death. In the face, these injuries can lead to disfiguring scars with lengthy treatments and aftercare. The associated psychological burden on the patient is an important aspect, which is often neglected [5]

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