Facial Dog Bite Research Articles

Repair of facial dog bite wound utilizing cryopreserved umbilical cord allograft.

In the United States, craniofacial injuries are the most frequently observed traumas in the pediatric population. Human birth tissue products contain growth factors, cytokines, and signaling molecules that can be potentially harnessed for tissue regeneration and wound healing. A cryopreserved ultra-thick amniotic membrane (AM) allograft wound dressing was used in a patient with significant facial soft tissue loss due to a dog bite injury. This is a single case report of a pediatric patient. After obtaining IRB exemption, operative and postoperative clinic notes were reviewed. A 10-year-old female presented to the emergency department after suffering a dog bite to her left cheek and upper lip, resulting in tissue loss. A cryopreserved ultra-thick AM allograft was used to cover the area of tissue loss as part of surgical reconstruction. The patient was followed up at 1 week, 3 weeks, 4 months, and 1 year after the graft was placed, and rapid healing and full epithelialization were achieved in addition to scar contracture due to wound location. In the setting of acute trauma and tissue loss, human birth tissue was found to promote epithelialization and regenerative healing of facial tissues.

Facial dog bites in children: A public health problem highlighted by COVID-19 lockdown

BackgroundStay-at-home injunction during COVID-19 pandemic led to new dynamics in households and increased the risk of domestic accidents involving pets. The aim of the study was to demonstrate an increase of facial dog bites in children during first lockdown period in France, compared to the same period in 2018 and 2019. Secondary objective was to investigate the demographics and circumstances in which dog bites occurred. MethodsA retrospective multicentric study was conducted nationwide. Patients under 18 years old managed in fifteen oral and maxillofacial surgery departments for a dog bite were included. ResultsEighty-seven patients were included. A significant increase of the number of children managed for facial dog bite was noticed in 2020 (p=0.0005). The male-to-female ratio was significantly reversed in 2020 with more bites in girls than boys (p=0.02). In 2020, children were mostly bitten to cheeks (28.6 %), lips-and-chin region (26.2 %), and eyelids (23.8 %). Severe bites increased in 2020, in comparison with 2018 and 2019. Dog bites occurring while petting or playing significantly increased in 2020 (31 %) (p=0.03). ConclusionThe process leading to bites is highly dependent on the balance of dog-owner relationship. This was strongly disrupted during COVID-19 pandemic, resulting in the increase of dog bites in households. Regarding dog bites, face is the most vulnerable area in children. Its injury has lots of esthetic and functional consequences and maxillofacial surgeons have a key role to play in their prevention. Reminders of some of these management and prevention strategies are presented in this article.

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.

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.

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.

Surgical management of facial dog bite trauma: A contemporary perspective and review.

To perform a review evaluating management of and complications stemming from dog bite trauma sustained to the head and neck over the past decade. PubMed and Cochrane Library. The authors searched the PubMed and Cochrane Library databases for relevant published literature. A total of 12 peer-reviewed canine-exclusive series inclusive of 1384 patient cases describing facial dog bite trauma met inclusion criteria. Wounds including fractures, lacerations, contusions, and other soft-tissue injuries were evaluated. Demographics related to clinical course and management, operating room requirements, and antibiotic usage were compiled and analyzed. Initial trauma and surgical management complications were also assessed. 75.5% of patients sustaining dog bites required surgical intervention. Of these patients, 7.8% suffered from postsurgical complications, including hypertrophic scarring (4.3%), postoperative infection (0.8%), or nerve deficits and persistent paresthesias (0.8%). Prophylactic antibiotics were administered to 44.3% of patients treated for facial dog bites and the overall infection rate was 5.6%. Concomitant fracture was present in 1.0% of patients. Primary closure, often in the OR may be necessary, with few cases requiring grafts or flaps. Surgeons should be aware that the most common complication is hypertrophic scarring. Further research is needed to elucidate the role of prophylactic antibiotics.

Cost Analysis of Follow-Up Care for Pediatric Facial Dog Bites.

Cost Analysis of Follow-Up Care for Pediatric Facial Dog Bites.

Early Childhood (0 to 5 years) Presents the Greatest Risk for Facial Dog Bites

The purpose of the present study is to compare the characteristics of dog bite wounds to the face and that of the rest of the body among the pediatric population in the United States and to determine independent risk factors for dog bite wounds to the face. A retrospective cohort study was conducted using the Kids' Inpatient Database. There were multiple, heterogenous predictor variables. The primary outcome variable was a facial dog bite. A multivariate logistic regression was employed to identify independent risk factors for the primary outcome variable. A P value less than .05 was the threshold for statistical significance. Our final sample consisted of 9,057 patients who suffered dog bite injuries, of which 2,913 (32.2%) occurred on the face. Relative to individuals aged 16-20years, individuals aged 0-5 (odds ratio [OR] 5.7; confidence interval [CI] 4.0, 8.1), 6-10 (OR 3.8; CI 2.6, 5.5), and 11-15 years (OR 1.6; CI 1.1, 2.5) were all independently associated with increased odds of incurring a facial dog bite injury. Patients who were not admitted electively were 2.5 times (CI 1.4, 4.6) more likely to incur a facial dog bite injury relative to patients who were admitted electively. Young children (0-5years) were at the greatest risk for facial dog bites relative to children aged 16-20years. Dog bites that were admitted on emergency were more likely to occur on the face relative to those that were electively admitted to the hospital. To reduce the risk for facial dog bites and the host of chronic psychological ramifications that accompany them, established preventative strategies ought to be exercised.

What factors influence the hospitalization outcomes of pediatric patients suffering facial dog bite wounds?

PurposeThe purpose of this study was to determine which factors are associated with increased hospital charges and length of stay among pediatric patients who incurred dog bites to the face. Materials and methodsThe following 12-year retrospective study was conducted using the Kids’ Inpatient Database (KID). We selected all cases of dog bites to the facial region. There were multiple heterogenous predictor variables. The primary outcome variables were hospital charges and length of stay. Linear regression was used to determine any variable that was independently associated with increased hospital charges and length of stay. ResultsOur final sample consisted of 4,395 subjects. Other subjects (i.e., Hispanic, Asian, and Native American) added +$ 3,744 (P < 0.01) in hospital charges. Fractures and vascular injuries added +$ 30,116 (P < 0.01) and +$ 106,331 (P < 0.01) in hospital charges respectively. Non-infected wounds added +$ 9,219 (P < 0.01) in hospital charges. Black subjects added +0.46 days (P < 0.05) to the length of stay. Fractures added +2.31 days (P < 0.01) to the length of stay while vascular injuries added +7.12 days (P < 0.01). Non-infected wounds added +0.45 days (P < 0.01) to the length of stay. ConclusionsFractures and vascular injuries significantly increased the hospital charges and prolonged the length of hospitalization. Black subjects were associated with prolonged hospitalization likely due to implicit bias. Other subjects were associated with increased hospital charges. Non-infected wounds were associated with significant increased hospital charges and prolonged hospitalization.

Retrospective Review of Facial Dog Bites Treated at MGH over a 20-year Period

Dog bites are consistently among the top 15 causes of nonfatal injuries in the general population and top 10 among 5-9 year olds.1 Children are more likely to be bitten than adults, and these bites are more likely to involve the head and neck region with potential for long-term aesthetic, psychological, and functional consequences.2 This serious public health issue has yet to be adequately addressed in terms of policy and education among vulnerable populations. In designing educational programs, there is a need to fully understand all potential risk factors and provocations. Currently, we lack sufficient knowledge of the circumstances surrounding the injury. This study aims to answer the following: In all patients presenting to a tertiary care hospital for treatment of a facial dog bite, are there identifiable risk factors associated with the injury? In particular, we wish to focus on those provocations and behavioral issues that can be modified in an effort to decrease the incidence of this devastating injury. This will help focus efforts on improved education and outreach programs and identify vulnerable populations who would most benefit. This is a retrospective study analyzing the facial dog bites treated at Massachusetts General Hospital from 1997-2018. Inclusion criteria, in addition to the diagnosis of facial dog bites, were records that included specific information about the circumstances surrounding the bite and descriptors of the type and location of the injury. Incomplete records resulted in exclusion. The predictor variables included: demographics of the victim (e.g., age and gender), circumstantial information regarding the injury (e.g., location of injury, relationship of victim to dog, provocational circumstances), and dog characteristics (e.g., dog breed, fate of attacking dog, and dog’s history of aggressive behavior). Data analyses were performed using IBM SPSS Statistics 25. Descriptive statistics, such as mean, range, and standard deviations, were calculated for applicable study variables. To measure the association among variables of interest, either bivariate t-tests or chi-square testing was performed for the appropriate variables. A P-value of .05 was considered statistically significant. A total of 321 patients were identified with a mean age of 29.5 years (range 0.7-81 years). There were 141 males and 180 females. The majority of patients were adults [> 18 years of age, n = 223(69.5%)]. A preponderance of dogs [n = 281(87.5%)] were known (P < .00001), and provocation was recorded in 207 cases (64.5%, P < .00001). Bites were preceded by the following behaviors: playing with, feeding, and placing face close to the dog. Pitbulls led in number of bites [n = 26 (8.5%)]. Location on the face was predominantly the middle or lower third [n = 299 (93.1%)]. The type of injury (often mixed) included 284 (88.5%) lacerations, 72 (22.4%) punctures, 48 (15.0%) avulsions, and 20 (6.2%) involving contiguous structures including the mental nerve, ear, gingiva, nasal cartilage, and Stenson’s duct. This study highlights the role of provocation in dog bite injuries and suggests that vulnerable populations may benefit from efforts aimed at improved education, outreach programs, and policy changes. Future initiatives will focus on mandatory documentation and reporting to ensure complete collection of information. More effective methods of promulgating educational information is required. Partnering with veterinarians, pediatricians, rescue and adoption agencies, and pet supply companies will help bring this about.

Facial dog bites treated at the Massachusetts General Hospital over a 20-year period.

The aim of this study was to identify risk factors associated with facial dog bites and discuss prevention strategies. This is a retrospective analysis of facial dog bites treated at the Massachusetts General Hospital (MGH) from 1997to 2018. Patients were identified through the Research Patient Data Registry. The predictor variables included demographic characteristics, circumstantial information regarding the injury, and dog characteristics. Other study variables were wound and treatment specifics and follow-up. Descriptive and bivariate statistics were computed. In total, 321 patients were identified (mean age 29.5 years; range 0.7-81 years). There were 141 males and 180 females. The majority of patients were adults (age > 18 years; n=223 [69.5%]). Most dogs (n=281 [87.5%]) were known (P < .00001), and provocation was recorded in 207 cases (64.5%; P < .00001). Bites were preceded by the following behaviors: playing with the dog, feeding the dog, and placing the face close to the dog. Pitbulls led in the number of bites (n=26 [8.5%]). Location on the face was predominantly the middle or lower third (n=299 [93.1%]). The results of this study suggest that education of dog owners, parents, and children should focus on avoidance of known provoking behaviors. This may help decrease the incidence of these devastating injuries.

Treatment of Facial Dog Bite Injuries in the Emergency Department Compared to the Operating Room.

ObjectiveTo assess factors associated with repair of facial dog bites in the emergency department (ED) versus the operating room (OR) and to compare rates of surgical site infection and reoperation for each venue.Study DesignCase series with chart review.SettingSingle institution.Subjects and MethodsAll patients younger than 18 years of age who underwent surgical repair by a consulting surgical service within 24 hours of presentation for facial dog bites between 2010 and 2013 were included. Demographics, site of injury, associated evidence of complex injury, surgical site infections within 30 days, and reoperation within 2 years were compared between patients undergoing surgical repair in the ED versus the OR.ResultsOne hundred sixty-five patients were evaluated; 75 patients underwent repair in the ED, and 90 patients were treated in the OR. Patients treated in the ED underwent surgery more promptly than patients treated in the OR (median time from arrival to procedure start 3.3 vs 6.8 hours, P < .001). Patients treated in the OR were more likely to have longer lacerations (3.0 cm vs 7.8 cm, P < .001), lacerations of the eyelid (17% vs 42%, P = .001), involvement of multiple regions of the face (11% vs 22%, P = .039), and multiple indicators of severe injury (3% vs 12%, P = .024). There were no differences in surgical site infections (1% vs 1%, P = .721) or reoperation rates (5% vs 13%, P = .071).ConclusionsSurgical management of pediatric facial dog bites may be successfully performed in both the ED and OR settings. Severity of the injury should dictate the choice for management.

Dog-Bite-Related Craniofacial Fractures among Pediatric Patients: A Case Series and Review of Literature.

Dog bites in the pediatric population commonly cause injuries to the head and can be associated with fractures, often leading to prolonged hospital stays, multiple surgical interventions, and long-term complications. Our goal was to evaluate our experience with dog-bite-related craniofacial fractures, understand frequency and demographics of these fractures, identify common fracture patterns, and provide recommendations based on management and complications encountered. The institution's electronic medical record was reviewed. A review of the English literature for the past 20 years was also conducted. A retrospective chart review was conducted using ICD-9 codes to include all patients with head and neck dog bites and craniofacial fractures. Fractures resulting from canine bites to the face and scalp were rare, occurring in our study in less than 1% of total facial dog bites (1,069 cases) and 1.5% of pediatric facial dog bites (462 cases). Ages ranged from 5 months to 9 years at the time of presentation. A total of seven patients, all pediatric, were documented. All seven patients required operative intervention for their wounds, and five patients required at least two operative interventions. Midface and skull fractures were the most commonly encountered fracture sites. Dog bite injuries to the face in young children, especially when severe, should raise suspicion for fracture of underlying bone. Management of these injuries should include a multidisciplinary approach and focus on repair of soft tissue and skeletal deformities. Furthermore, it is prudent to follow up patients who require operative management after injury to monitor for long-term complications, given the significant proportion of complications and operative takebacks in this study.

Dog bite injuries to the face: Is there risk with breed ownership? A systematic review with meta-analysis

IntroductionDog bite injuries to the face are a serious, yet modifiable public health concern. This study explores the relationship between dog breed and the risk of biting and injury. The objective of this study is to determine the relative risk and severity of dog bite injuries to the face by breed. MethodsRetrospective chart review of facial dog bite injuries presenting to the University of Virginia Health System and Nationwide Children's Hospital. Additionally, descriptive data was collected from 240 patients over the last 15 years. Bite risk by breed was assessed by a literature search from 1970 to current. A composite measure was used to determine the severity of injury, and characterize each patient into an ordinal scale of bite severity. An average of each breed bite rate within each study was calculated and combined to create an empiric bite risk by breed. Dog breeds were also further characterized morphologically. ResultsBite risk by breed from the literature review and bite severity by breed from our case series were combined to create a total bite risk plot. Injuries from Pitbull's and mixed breed dogs were both more frequent and more severe. This data is well-suited for a bubble plot showing bite risk on the x-axis, bite severity on the y-axis, and size of the bubble by number of cases. This creates a "risk to own" graphic for potential dog owners. ConclusionsBreeds vary in both rates of biting and severity. The highest risk breeds had both a high rate of biting and caused significant tissue injury. Physical characteristics can also help determine risk for unknown or mixed dog breeds. Potential dog owners can utilize this data when assessing which breed to own.

Diverse spectrum of facial dog bite presentation and their management

Background: Dog bite patients are frequently encountered in our hospital seeking immediate as well as delayed reconstruction. More than two third of dog bite injuries involve head, neck and scalp region. Facial dog bites present a challenge for the surgeon, as they lead to cosmetic disfigurement and psychological trauma to the patient. Following thorough washout and debridement, we have used various reconstructive techniques for definitive management of wounds like- primary repair, V-Y advancement flap, nasolabial flap, SSG, FTG and Karapandzic flap. Purpose of the present study is to share our experiences in management of dog bite wounds on the face in both adult and paediatric patients with available reconstructive options to maximize the functional and cosmetic outcomes by using basic principles of surgery.Methods: Present study was a single centre retrospective study conducted in a tertiary care centre from February 2013 to January 2018. Total 497 patients of dog bite who presented in the emergency department were enrolled. Out of them 310 patients had involvement of head, neck and scalp requiring surgical intervention in any form.Results: In last five years, we have encountered mid face predilection in face, head and neck cases. Out of 310 cases, lip (25.16%) and cheek (24.51%) were involved in majority of the patients. Flap cover surgery is required in majority of the scalp and nose group of patients, as there is less mobility of tissue present in surrounding region, while cheek and lip were managed with primary closure in most of the patients.Conclusions: Although most of the dog bites are preventable, but cases of dog bite are increasing continuously. Child should never be left alone with dogs and, if they are fear of dogs, it’s better not to obtain dogs. As far now, it’s a major concern for treating physician or surgeon to provide optimal cosmetic as well as functional outcome. Early surgical intervention for wound management gives better results with the use of basic principles of plastic surgery.

Microvascular Replantation Following Facial Dog Bites in Children: Systematic Review and Management Algorithm.

Pediatric dog bite injuries account for 1% of emergency department visits per year and represent an underrecognized and underreported public health problem. Reconstructive surgery is frequently utilized, and in the most extreme injuries, microvascular replantation may be considered. We sought to systematically review the available literature on microvascular replantation after facial dog bite injuries in children, with particular attention to perioperative morbidity and long-term follow-up. We reviewed a case of microvascular replantation after a facial dog bite injury in a child from our own institution and conducted a systematic literature search to identify other similar reports. Clinical variables were collected from the reported cases, and descriptive statistics were calculated. A management algorithm was developed from the reviewed published experience. We report the youngest child to date in the literature to undergo replantation after a facial dog bite injury. Nineteen other cases were found involving children aged 18 months to 17 years, with follow-up ranging from 2 weeks to 28 years. Anastomosis techniques varied considerably and included both an artery and vein in only 9 (47%) of 19 cases. Venous congestion was nearly universal, and multimodal techniques were used until native venous outflow was reestablished. Blood transfusion was common, but intensive care unit utilization was not frequently reported. Long-term outcomes were excellent, with growth of the replanted part and recovery of function; however, minor revision procedures were common. Microvascular replantation following facial dog bite amputation injuries in the pediatric population is the ultimate step in the reconstructive ladder. Strong consideration should be given to microvascular exploration with involvement of large or whole segments of the lip, nose, or ear; however, parents should be counseled extensively regarding the known morbidity of replantation surgery. With meticulous surgical technique and careful postoperative care, replantation after facial dog bite amputation injuries may successfully achieve dramatic and lasting results for pediatric patients.

Ophthalmic Manifestations of Facial Dog Bites in Children.

To characterize ophthalmic manifestations and periocular injuries of pediatric facial dog bites. A retrospective review of all children younger than 18 years who sought medical attention after a dog bite to the face between January 1, 2003 and May 22, 2014 was performed at a large tertiary pediatric hospital. Data on type and location of injury, surgical intervention, and complications were collected. A total of 1,989 children aged 0.19 to 17 years were identified with dog bites. Dog bites to the face occurred in most patients (n = 1, 414 [71%]). Of those children with facial dog bite injuries, 230 (16%) suffered ophthalmic manifestations. The average age was 4.3 years. Eyelid injuries occurred in 227 (99%) of children, 47 (20%) sustained canalicular system injuries, 3 (1.3%) suffered corneal abrasions, and 2 patients sustained facial nerve injury resulting in lagophthalmos. No patients suffered vision loss. Complications occurred in 32 patients (14%), with the most common being epiphora in 9 patients (28%), upper eyelid ptosis in 8 (25%), and prominent scar formation in 4 patients (13%). Thirteen children (5.7%) needed one or more secondary procedure to correct complications. The authors report the clinical features and management on the largest series of ophthalmic and periocular injuries associated with pediatric facial dog bites. These injuries occur in about 1 in 6 dog bites to the face and primarily involve the ocular adnexa. Despite early and appropriate surgical management, complications and the need for revision surgery are relatively common.

Retrospective Analysis of Facial Dog Bite Injuries and Surgical Management at Plastic Surgery Centre: 10 Years' Experience, Vilnius University Hospital, Lithuania

Introduction: Facial dog bites injuries are high risk of contamination, complex and cosmetic outcome is at its great importance. Methods: 81 consecutive patients (46 adults and 35 children) treated for facial dog bite injuries at Plastic and Reconstructive Surgery Centre of Vilnius University Hospital, Lithuania between 1993 and 2012 were retrospectively reviewed. The following information recorded: age, number of facial aesthetic units involved, tissue loss, the duration between injury and surgical repair, type of repair, and complications. We divided patients in to two groups for analysis of the results. Patients with one facial aesthetic unit involved and patients with more than one aesthetic unit involved. Results: First group of the 54 patients (38 adults and 16 children) with one facial aesthetic unit involved. 47 out of 54 wounds were with tissue loss, 7 out of 54 bite wounds without tissue loss. All 7 wounds without tissue loss were directly repaired. Out of 47 wounds with tissue loss 2 were directly repaired, 2 left to heal by secondary intention and 43 required reconstruction surgery with composite graft, skin graft, local or regional flaps. 76% of repairs were performed within 24hours from the injury. 7 complications (13%) were recorded. 1 wound infection after direct closure and 6 out of 7 (86%) complications were composite graft loss. Second group of 27 patients (8 adults and 19 children) with more than one facial aesthetic unit involved. All 14 cases without tissue loss underwent primary closure. Out of 13 wounds with tissue loss 1 repaired directly, 12 required reconstructive surgeries. In this patient group were 5 complications (19%). Conclusions: Children are more likely to sustain injury to multiple facial aesthetic units following dog bite. Direct repair of facial dog bite injuries is safe.

The impact of facial dog bite injuries on patients, and OMFS practice: results of a 3 year review

The impact of facial dog bite injuries on patients, and OMFS practice: results of a 3 year review

A Stich in Time Saves Nine: Primary Closure in Facial Dog Bite Injuries - A Case Series

The purpose of this article is to present a case series of facial dog bites injuries, its management and emphasize the importance of primary closure. Animal bite injuries, unlike wounds caused by assaults and accidents, are more distinctive, as they cause deep puncture wounds. Such wounds are inoculated with pathogenic bacteria from the saliva of the attacking dog due to the penetration of tissue by excessive bite force. Hence, these wounds are at a high risk of infection. The key point in its management is thorough cleansing, meticulous but not overzealous debridement, followed by rabies immunization, tetanus immunization, primary closure, and appropriate antibiotic therapy. A retrospective study of 27 cases that underwent primary repair or reconstruction after wound toilet, debridement and administration of prophylactic antibiotics has been presented.