How are wounds managed following an animal bite?

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

Oehler and colleagues proposed the following wound management strategy following animal bites, aimed at preventing severe complications [24] :

  • Culture for aerobes and anaerobes if abscess, severe cellulitis, devitalized tissue, or sepsis is present

  • Use saline solution for wound irrigation

  • Debride necrotic tissue and remove any foreign bodies

  • If fracture or bone penetration has occurred, radiography is indicated (MRI or CT may also be indicated)

  • Initiate prophylactic antibiotics in selected cases (based on type and specific animal species involved)

  • If methicillin-resistant Staphylococcus aureus (MRSA) is suspected, first-line antibiotics include trimethoprim-sulfamethoxazole, doxycycline, minocycline, and clindamycin [25]

  • Hospitalization is indicated if fever, sepsis, spreading cellulitis, severe edema, crush injury, or loss of function is present

  • Administer tetanus booster (if none given in past year) or initiate primary series in nonvaccinated individuals (see Tetanus for further recommendations)

  • Assess the need for rabies vaccine and immunoglobulin (see Rabies for further recommendations)

For additional information, see Medscape's Wound Management Resource Center.


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