Dog Bite Injuries Research Articles

Incidence of facial fractures in association with facial laceration from dog bites in the pediatric patient.

Dog bite injuries occur in approximately 102 of every 100,000 population. Pediatric facial injuries due to dog bites are more common than in the adult largely due to height difference and ease of access for the dog to the head and neck region. Although majority are soft tissue injuries, pediatric facial fractures from dog bites are estimated at approximately 5%, with the true incidence unknown. We hypothesize that depth and facial subsite of laceration can indicate likelihood of facial fracture presence in pediatric patients with dog bite injuries. This single-institution retrospective study included 162 patients 18 years or younger (n=162) who had an ICD-9 code of E906.0 or ICD-10 code of W54.0 for dog bites in the head and neck region between 1/1/2015 and 12/31/2019 and were treated in the emergency department by either an emergency department, otolaryngology, or plastics surgery provider. Multivariable logistic regressions were used to examine the association between patient age, sex, and dog size, and the outcomes: laceration depth (epidermis, dermis, muscle, bone), and facial subsite (upper, middle, lower third). Males had a lower laceration penetration at the epidermis level (aOR=0.36; 95% CI 0.19, 0.69) but a higher laceration penetration at the muscle level (aOR=2.29; 95% CI 1.04, 5.04) compared to females. No significant findings were observed for the levels of dermis and bone. In the multivariable analysis, there were no significant associations to suggest facial fractures found between facial subsites and age, sex and dog size. No significant associations between depth or facial subsite of facial injury from dog bites and the presence of facial fractures in pediatric patients except with regard to male sex and laceration level of epidermis and muscle.

Dog Bite Injury on The Face of a Patient with an Alloplastic Implant

In Mexico, dog bite injuries have an incidence of 110.44 per 100,000 inhabitants. In more than half of the cases the attack was by family or neighbor dogs; an important factor in determining the severity of the injuries is the breed of the dogs. Of the bites on the face, the nose and lips are the most affected sites. Bites in this area should be sutured soon because of the infrequent infectious complications. A clinical case is presented of a 62-year-old female patient who was bitten on the nose and lip by her Rottweiler breed dog while being fed.

A 4 year retrospective study of facial dog bite injuries in patients reported to pediatric emergency, BPKIHS, Nepal.

Introduction: Dog bites facial injuries are a significant health care problem and their sequelae ranges from minor to fatal injuries.
 
 Objectives: To determine the incidence of facial dog bite injuries and to assess the outcome as well as presentation of facial injuries among the children reported to the pediatric emergency, BPKIHS, Nepal.
 
 Methodology: A study was conducted where the clinical records of children with facial dog bite injuries reported from 2015 to 2018, were assessed and analyzed.A proforma was designed to extract relevant clinical data from the case records. Information such as age, gender of the victims, anatomical site of the injury, interval between injury and presentation to the hospital, nature of injuries,profile(stray or pet)and immunization status the of dog ,outcome and complications were extracted.
 
 Results: The incidence of facial dog bite injuries has significantly increasedpointing maleschool going children injured predominantly(70%).Seventeen(81%) victims had presented within 24 hrs of injury whereas two(9.5%) patients had reported after 24 hours and 72 hours of the injury. Nineteen patients were treated on the same dayunder local anesthesia, one under general anesthesia where thorough wound lavage with meticulous reapproximation followed by suturing was done. Full recovery was evident in eighteen (86%) cases with primary wound closure whereas two (14%) patients had undergone healing with secondary intention.
 Conclusion: There is an increase in incidence of dog bite facial injuries among children in our tertiary health care centre. Satisfactory healing outcomes were achieved with a thorough wound lavage and primary closure of non-infected wounds under appropriate rabies prophylaxis and proper antibiotic regimen.

Epidemiology of dog bites to people in Uruguay (2010-2020).

Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID-19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries. The main objectives of our study were to determine the prevalence of dog-bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre-pandemic years. Cross-sectional study. Dog-bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health. The annual dog-bite injury rate for the 2010-2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims' sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog-bite injuries when comparing 2020 with the pre-COVID-19 pandemic years. In Uruguay, the frequency of dog-bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID-19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.

Epidemiological pattern and management of dog bite injuries in Karachi, Pakistan: A cross-sectional study

BackgroundDog bite injuries are a common problem globally; however, little is known about the epidemiology of dog bite injury from a low-and-middle-income country like Pakistan. This study aims to determine the epidemiology of dog bite injuries among children and adults from a tertiary care hospital in Karachi, Pakistan. MethodsWe conducted a cross-sectional study on dog bite patients visiting the emergency department from November 2015 to August 2016 of a major public tertiary care hospital. Data was collected using a structured questionnaire on demographic details, bite history, and management of dog bite victims. Descriptive analysis was reported. Chi-square test was applied to check the associations between age-specific dog bite cases and independent variables. Results2178 participants were included in the analysis. 715 (38.8%) were children less than 18 years old, and 1463 (61.2%) were adults over 18 years. A majority of the patients were males (1909, 87.7%). Results show that most dog bite injuries (2052, 94.2%) tend to occur outside the house by stray dogs biting without provocation. People aged 18 years and above (61.2%) and males (children: 84.6%, adults: 89.1%) tend to be bitten more often. Lower limbs are most frequently bitten (children: 69.5%, adults: 85.8%). Free-roaming stray dogs (children: 73.4%, adults: 74.9%) were involved in reported biting cases. Many of the patients did not receive appropriate first aid and instead just washed the wound with soap and water (children: 45.1%, adults: 43.7%). 99% of the victims received Tetanus toxoid, Rabies vaccine, and immunoglobulins while in the emergency department. ConclusionThere is a high burden of dog bite injuries from stray dogs in Karachi, Pakistan. Efforts should be made to create awareness among the general public on the risks of dog bites and on seeking appropriate first aid and medical attention for a dog bite injury.

A Retrospective Observational Study of Facial Dog Bite Injuries and Its Management in a Tertiary Care Center.

Background : Facial dog bite injuries result in significant emotional, psychological, and physical trauma to the victims involved and should be considered a significant health issue. The purpose of this study is to share our experience in the management and to add to the existing medical literature regarding the epidemiological patterns of facial dog bite injuries. Materials and Methods : This is a single-center retrospective observational study conducted at Dr. RML Hospital, New Delhi, from January 2021 to January 2022. A total of 105 patients were included. The wounds were managed according to the recommendations made by the national rabies control program and surgical intervention was performed in the form of primary suturing or flap cover. Results : Children of age group 0 to 10 years are most commonly affected. Pet dogs are the cause in 61% of cases and 57.1% of bites were provoked. Midface is most commonly affected and modified Lackmann's class 3A and 3B are the most common wounds. Conclusion : In view of raising incidence of dog bites with pet dogs, the general public needs to be educated regarding the practices to prevent these injuries. Postexposure prophylaxis should be given to all affected individuals irrespective of the vaccination status of the dog. Immediate surgical intervention gives better results.

Analysis of Reported Dog Bite Data in Government Hospitals of Various Districts in Punjab, Pakistan

Background: Rabies is a neglected and underestimated national public health issue in Pakistan. Freeroaming dogs are the principal reservoir and also potentially cause thousands of dog bite injuries in different age groups of people. Objectives: The present study was designed to evaluate the burden and frequency distribution of total dog bite injuries in Punjab. The comparison of total dog bite injuries between 2019 and 2020 were made to understand whether there is significant difference in total number of dog bite injuries in 2019 and 2020. Methods: Total dog bite data from public sector hospitals of Punjab province were collected for the time period between January 2019 to December 2020 with the help of District Health Information System (DHIS) which is a comprehensively designed digital program. Descriptive measures and the graphical representation were used to describe and interpret the said data. A non-parametric test (Mann-Whitney test) was used to compare the median number of dog bite injuries in 2019 to 2020. Results: Results show that more than 0.2 million number of dog bite injuries have been recorded in 2019 and 2020. The medium number of the dog bite injuries in 2019 and 2020 were statistically significant, having pvalue

Factors affecting length and complexity of hospital stay in pediatric dog bite patients

BackgroundDog bite injuries are a source of significant morbidity and expense in the USA, and rates of hospitalization have been rising. Children are at increased risk of dog bites compared...

Clinical and epidemiologic features of persons accessing emergency departments for dog and cat bite injuries in California (2005-2019).

To describe the clinical and epidemiologic features of persons with dog and cat bite injuries who presented to emergency departments. Records of 648,492 dog and cat bite-related emergency department visits in California from 2005 to 2019. Visits were selected by standardized International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification codes that indicated a bite as an external cause of injury in the medical record. Incidence rates were calculated for patient demographics, location and month of bite incident, characteristics of bite injury, infection, patient outcome/disposition, and expected source of payment. Cross-sectional descriptive analysis was performed. The average annual incidence of dog bites was highest in children aged < 10 years and males, while that of cat bites was highest in adults aged ≥ 80 years and females. Bites were more likely to occur in rural settings, in private residences, and during the summer. The median household income for zip codes in which animal bite patients resided was lower than the statewide median household income. Both dog and cat bite injuries were more likely to occur to upper limbs. Bacteria were isolated from 3% of dog bite injuries and 21.5% of cat bite injuries at initial presentation. Epidemiologic findings about persons presenting to emergency departments for animal bite injuries can inform bite prevention efforts by identifying at-risk populations. Effective animal bite prevention demands an ongoing multisectoral program of veterinarians and other health professionals, collaborating with community and governmental organizations, to develop and implement integrated strategies within the context of other socially contributory factors.

MRI and CT findings of compressive cervical myelopathy in a dog with suspected immune‐mediated polyarthritis presenting with tetraparesis

AbstractAn 11‐month‐old, male, entire Great Dane dog presented with acute‐onset non‐ambulatory tetraparesis. Three months before presentation, the dog was treated for a suspected dog bite injury. Examination revealed pyrexia (39.7°C) and marked multiple joint swelling, with cervicalgia and non‐ambulatory tetraparesis. Based on clinicopathological findings and diagnostic imaging, a diagnosis of type II immune‐mediated polyarthritis was reached. The tetraparesis was investigated using magnetic resonance imaging and computed tomography, allowing the identification of compressive cranial cervical myelopathy secondary to severe occipitoatlantoaxial joint and multiple facet joint distension. The patient was initially treated with antimicrobial therapy with resolution of the pyrexia. Given the persistent severe multiple joint swelling and tetraparesis, immunosuppressive therapy was started. Due to refractory disease and poor prognosis, euthanasia was elected 97 days following presentation. To the authors’ knowledge, compressive cervical myelopathy associated with immune‐mediated polyarthritis has not been previously reported in the veterinary literature.

Analysis of primary repair in cases of ocular dog bite injury

Ocular dog bite injuries are reported mostly in children and are commonly associated with severe adnexal injuries. We studied six ocular dog bite injuries that presented in the emergency unit of a tertiary institute within six hours of injury between April 2021 and March 2022. All patients had lid laceration and one case had canalicular tear with severe tissue loss in the lower lid. Wound apposition was done with loose sutures on skin and minimal trauma to tissues. Wound healing was good in all cases. This approach of lid injury repair helps to reduce chances of infection while achieving good cosmesis.

Epidemiological characteristics, seasonality, trends of dog bite injuries, and relationship with meteorological data.

Animal bites are among the most critical in public health problems. Dogs are the leading cause of bite injuries. The study aimed to investigate the epidemiology and clinical features of dog bite cases admitted to an emergency department, as well as their temporal trends, seasonality, and tr relationship with meteorological data. Study data comprised eight years (2012-2019) emergency room records of a tertiary center. Demographic characteristics of the cases, bite anatomical area, treatment applied, hospitalization, and death rates were determined. The incidence rates and distribution of meteorological data by years were examined using ANOVA and Kruskal Wallis tests. Seasonality and temporal trends were investigated for incidence rates using the additive decomposition technique. The temporal relationship of incidence rates with meteorological data was evaluated using the Autoregressive Distributed Delayed Boundary Test. Causality verification was perfoirmed using the Granger test. Dog bite cases consisted of 1,335 records of partients with a mean age of 26.6±0.2 years. Bite cases were most common in the 20-44 age group (44.7%), males (76.4%), and lower extremities (48.2%). The frequency of hospitalization was 4.1%. Annual incidence rates ranged from 52.7-49.9/100,000, with a non-significant increasing trend. The incidence of bites had two peaks, in June and August. A co-integration relationship was observed between incidence rates and air temperature and humidity levels (p<0.001). Effective implementation of prevention programmes is needed for high-risk demographic groups. In addition, a national monitoring and reporting system could evaluate the effectiveness of any prevention programme and reduce the incedence of dog bites.

The K9-Teen Pandemic: When Good Boy Goes Bad. The Epidemiology, Management and Public Health Ramifications of Facial Dog Bite Injuries: Newcastle, Australia, Experience.

The purpose of this study was to investigate the epidemiology, pattern of injury and management of facial dog bite injuries. Methods: The authors conducted a retrospective cohort study over a 5-year period of patients who sustained a facial dog bite injury. The study setting was an Oral and Maxillofacial Surgery Department at a level 1 trauma centre, servicing an estimated catchment population in excess of 950,000 people. Results: In total, 171 patients were managed in the designated period from January 2017 to January 2022. The median age was 9years (range 11months to 77years), with the highest incidence of a single age 4years. The frequency was slightly greater amongst males (n = 93) than females (n = 78). The most common responsible breed were Pitbull types (n = 26). Overall, bites most often resulted from the family dog (n = 87), in the victim's own home (n = 84) and whilst playing with the dog (n = 64). The primary sites involved were the lips (n = 70), cheek (n = 53) and nose, representing the so called 'target area'. In 53 cases, the injuries were classified as severe. 138 patients required hospital admission, and of these, 130 required surgical management under general anaesthesia. Conclusions: Facial dog bite injuries present a significant burden on the healthcare system and result in physical, functional and/or emotional distress for the patient. As the rates of dog ownership continue to rise, a consequential increase in these injuries is also likely. Further, public health intervention is essential, particularly as the most susceptible demographic remains young male children.

A 10-year retrospective analysis (2012-2021) of hospitalizations resulting from dog bites in Southern Italy.

This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0-5 years), school-age children (6-12 years), teenagers (13-19 years), young adults (20-39 years), middle-aged adults (40-59 years), old adults (60-74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565-0.731) to 1.162 in 2021 (95%CI 1.078-1.247, P < 0.01). Incidence for both male and female victims also increased over the studied period (P < 0.05). We found an increasing trend of incidence in young and middle-aged adults (P < 0.05 and P < 0.005 respectively). Moreover, the most frequently injured age group by dogs was the preschooler group and, whilst we found a lower risk of being injured for males older than 20 years, no difference with females was observed. The location of lesions depended on the age group (P < 0.001). The number of days of DBIH increased significantly with age (P < 0.01). The increase of DBIH represents a public health problem that requires the development of preventive approaches.

Pediatric Dog Bites to the Face May Have Been Less Severe During COVID-19 Pandemic: A Retrospective Cohort Study

Pediatric dog bite injuries are one of the most common nonfatal injuries. During the COVID-19 pandemic, children stayed at home more than pre-pandemic. The effect of the pandemic on severity of dog bites to the face in children has not been examined. The objective of this study was to determine the frequency and severity of dog bite injuries to the face in children during the first year of the COVID-19 pandemic when compared to the previous year. A retrospective cohort study was conducted for children with dog bite injuries to the head and neck region who presented to the emergency department at Children's Healthcare of Atlanta from March 2019 to March 2021. The predictor variable was the time of injury, and this was divided into pre-lockdown [control group (March 15, 2019, to March 15, 2020), ie pre-L] and lockdown (March 15, 2019, to March 15, 2020), ie post-L. The outcome variable was severity of dog bite defined as one or more of the following: 1) patient required sedation or general anesthesia for repair, 2) 3 or more regions in the head and neck were involved, and/or 3) surgical consultation took place. The investigators used a two-sample t-test, multivariable linear regression models, and modified analysis of variance and multivariate ANOVA tests to analyze the data (P-value < .05 determined significance). 712 children (370 males) with an average age of 6years old (range, 7months-18years) fit the inclusion criteria. There were 381 cases in the pre-L and 331 in the post-L period. There were more cases on average per month pre-L (31.8 cases/month) than post-L (27.6 cases/month) (P-value=.26). There were 183 pre-L surgical consults compared to 75 post-L (48 vs 22.8% of cases, respectively; P-value ≤ .001). There were 52 pre-L cases that had 3 or more sites in the head and neck compared to 28 during the post-L period (P-value=.032). During the COVID-19 pandemic, there may have been a decrease in the severity of dog bite injuries. This trend may demonstrate a consequence that is not a direct result of the virus.

The Association of Antimicrobial Prophylaxis With Return Visits After Dog Bites in Children.

Dog bites occur frequently in the United States, yet there are no clear guidelines for prescribing antibiotic prophylaxis in healthy children after a dog bite. The aim of our study was to assess antibiotic prophylaxis and subsequent rates of infection after dog bites in children. We hypothesized a negative association between prophylactic prescription of any antimicrobial and return visit within 14 days for infection. In this retrospective cohort study, we assessed the frequency of antibiotic prophylaxis prescribed after dog bite injuries in patients 0 to 18 years old and subsequent return visits for infection using 2016 to 2017 medical and pharmacy claims derived from the IBM MarketScan Research Databases. We used the International Classification of Diseases-10 code W54 for dog bites then used keyword searches to find diagnoses (including infection), wound descriptions, and medications. Over the 2-year period, 22,911 patients were seen for dog bites that were not coded as infected. The majority, 13,043 (56.9%), were prescribed an antibiotic at the initial visit and 9868 (43.1%) were not. Of those prescribed antibiotics, 98 (0.75%; 95% confidence interval [CI], 0.60-0.90) returned with an infection, compared with 59 (0.60%; 95% CI, 0.44-0.75) of those not prescribed antibiotics. Receiving an antibiotic prescription at the initial visit was associated with a reduced rate of return for wound infection only among children whose wounds were repaired or closed. Children not receiving a prescription whose wounds were repaired were more than twice as likely to return with an infection in the subsequent 14 days as children whose wounds were not repaired (odds ratio, 2.2; 95% CI, 1.2-4.0). Most children are prescribed antibiotics at an initial emergency department visit after a dog bite. However, very few return for infection independent of antimicrobial prophylaxis, which suggests antibiotics are overprescribed in this setting.

Management of Dog Bite Injuries: Procedural Sedation, Infection, and Operative Indications at a Single-Institution Level I Pediatric Trauma Hospital.

Dog bite injuries are common within the pediatric population. Currently, there are inconclusive data on best sedation practice, antibiotic regimen, and need for plastic surgery referrals for treatment of dog bite injuries in the emergency department (ED) versus operating room (OR). This study set out to determine sedation practice, infection management, and necessity for plastic surgery referral at a level I pediatric trauma center. A retrospective review of all pediatric (0-18 years old) dog bites documented in electronic medical records from January 1, 2010, to December 31, 2019, was performed. Bitten by dog encounters were identified by International Classification of Diseases, Ninth Revision and Tenth Revision codes E906.0 and W54.0, W54.0XXA, and W54, respectively. Data gathered included age, gender, month of injury, circumstance of injury, injury characteristics, location of repair, person performing repair, sedation (if used, then length of sedation), inpatient admission, antibiotics prescribed, dog characteristics (breed, size, sex, age, relationship to patient), and complications. Summary statistics were calculated as mean ± SD. Comparisons for nominal variables were performed using the χ2 test. All analyses were performed using Stata v.16. 1. A total of 1438 pediatric patients were included in this study over a 10-year period. Of injuries requiring repair (n = 846), most repairs were performed in the ED (97.1% [822/846]), whereas 24 (2.8%) required repair in the OR. Of the bites that required repair (n = 846), 81.1% (686/846) were performed by an emergency medicine physician and 147 (17.4%) by plastic surgeons. Procedural sedation in the ED was performed in 146 repairs (17.3%). Documented sedation time ranged from 10 to 96 minutes. Most patients received a prescription for antibiotics (80.5%), usually amoxicillin/clavulanate (90.8%). Infection was the most common sequela (9.5%). There was no significant difference in infection rates between repairs performed in the ED versus those in the OR. Our study indicates that pediatric patient dog bite injuries can be successfully managed in an ED. Procedural sedation has demonstrated no increased safety risks compared with the OR. Rates of infection are also not demonstrated to be significantly higher in repairs done in the ED versus those taken to operating theater.

Penile glans amputation and caverno-spongiosal disjunction following a dog bite: a case report

 Traumatic penile amputation is a rare surgical emergency. Successful surgical reimplantation is very challenging even in the hands of experience surgeons. We report the case of 13-year-old boy who presented with traumatic penile amputation with complete urethral section and caverno-spongiosal disjunction. This resulted from a dog bite injury which occurred 2 hours before consultation. Following primary and secondary surveys, the emergency management consisted of resuscitation, broad spectrum antibiotics and tubulisation of the sectioned urethra. Urethroplasty and subsequently a caverno-spongioplasty were then performed. The post-operative follow-up was uneventful and immunisation against rabies was done. Erection with the catheter in place was normal upon control. Patient was re-evaluated 8 years later and had a cosmetically acceptable penis and void with a good urinary stream. Microscopic penile reimplantation remains the gold standard though challenging and unavailable especially in resource limited settings. However, non-microscopic genital reconstruction is possible with satisfactory cosmetic and functional outcomes.

Study of dog control strategies

Objectives(1) To explore the relationship between regionally implemented dog control strategies and dog bite injuries (DBIs) and (2) to evaluate current implementation of dog control strategies.MethodsObservational study using a nationwide...

Legal epidemiology of paediatric dog bite injuries

BackgroundDog bite injuries cause over 100 000 paediatric emergency department visits annually. Our objective was to analyse associations between regional dog ownership laws and incidence of paediatric dog bites.MethodsThis observational...