How should animal bite wounds be irrigated?

Updated: Sep 18, 2018
  • Author: Alisha Perkins Garth, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Irrigation is a key means of infection prevention. A 19-gauge blunt needle and a 35-mL syringe provide adequate pressure (7 psi) and volume to clean most bite wounds. In general, 100-200 mL of irrigation solution per inch of wound is required. [17] Heavily contaminated bite wounds require more irrigation. Large dirty wounds may require irrigation in the operating room. If available, povidone-iodine solution has been shown to be virucidal and is recommended for irrigation by the US Centers for Disease Control (CDC) if there is concern for rabies. A 10% solution can be diluted (10 or 20:1) and used to both cleanse the surface of the wound as well to irrigate. [18] Additionally, isotonic sodium chloride solution or tap water are safe, widely available, effective, and inexpensive irrigating solutions. Few of the numerous other solutions and mixtures of saline and antibiotics have any advantages over tap water or saline. [17] If a shieldlike device is used, take care to prevent the irrigating solution from returning to the wound, which may decrease the effectiveness of the irrigation.

It may be difficult to appropriately irrigate small puncture wounds, especially those inflicted by the teeth of a cat. Given that these have a higher rate of infection, consideration should be given to opening the wound with a No. 15 scalpel and creating a 1- to 1.5-cm incision that can be well irrigated and left open to heal by secondary intention. [19]

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