Oral and Maxillofacial Surgery

, Volume 22, Issue 1, pp 77–81 | Cite as

Human bite injuries to the head and neck: current trends and management protocols in England and Wales

  • Glyndwr W. JenkinsEmail author
  • Robert Isaac
  • Shakir Mustafa
Original Article



Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper.

Materials and method

A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate. The collated results of the survey were entered onto a spreadsheet (Microsoft Excel©) for the purpose of statistical review.


A 68% response rate from A&E departments throughout England and Wales demonstrated a lack of consensus in the initial management and subsequent treatment of human bite injuries. Written protocols are in place for human bite injuries in 54.4% of units. In 100% of units, initial management involves irrigation +/− debridement of the wound, though there is a lack of agreement on the surgical management of the wound. 77.9% of units follow ‘needle stick protocols’ when stratifying risk for blood-borne viruses.


Human bites pose a number of unique problems, ranging from cellulitis to the transmission of communicable diseases. The maxillofacial surgeon has the added dilemmas surrounding subsequent repair and reconstruction. Appreciation of the complexity of human bite injuries will ensure optimal care for the patient. We propose a set of guidelines developed ‘in-house’ to assist in the management of human bite injuries.


Human bite Treatment protocols Blood-borne viruses 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

10006_2018_670_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)
10006_2018_670_MOESM2_ESM.docx (133 kb)
ESM 2 (DOCX 132 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Glyndwr W. Jenkins
    • 1
    Email author
  • Robert Isaac
    • 2
  • Shakir Mustafa
    • 2
  1. 1.Sunderland Royal Hospital, City Hospitals SunderlandSunderlandUK
  2. 2.Prince Charles HospitalMerthyr TydfilUK

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