How is infection prevented in animal bite?

Updated: Sep 18, 2018
  • Author: Alisha Perkins Garth, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Facial wounds have a low risk of infection even when closed primarily due to their increased blood supply. [10, 23, 20] A randomized clinical trial showed no increased risk of infection (without the use of prophylactic antibiotics) and improved wound healing times with primary closure of facial wounds from dog bites. [23] Given the cosmetic implications of facial wounds, primary closure is therefore advisable.

Primary closure should only be considered in bite wounds that can be cleansed effectively. Bite wounds to the hands and lower extremities, with a delay in presentation (>8-12 hours old), or in immunocompromised hosts, generally should be left open or treated by delayed primary closure. [10] Closure management decisions should be at the discretion of the provider after discussion with the patient and consultation with specialists if available. Deep sutures should be avoided because they can act as a nidus for infection.

If a bite wound involves the hand, consider immobilizing the hand in a bulky dressing or splint to limit use and promote elevation.

Consider tetanus and rabies prophylaxis for all wounds. Antirabies treatment may be indicated for bites by dogs and cats whose rabies status can not be obtained, or in foxes, bats, raccoons, or skunks in the Americas (see Rabies and Tetanus for treatment and dosing information).


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