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Management of bite wounds in children and adults—an analysis of over 5000 cases at a level I trauma centre

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Summary

Background

Bite wounds are among the commonest types of trauma to which man is the subject. They account for 5 % of the total traumatic wounds evaluated in the emergency department (ED) and approximately 1 % of all the ED visits. Early estimation of infection risk, adequate antibiotic therapy and if indicated surgical treatment are the cornerstones of successful cure of bite wounds.

Methods

A total of 5248 consecutive trauma patients were collected prospectively and analysed retrospectively over a period of 15 years in this study at a level I trauma centre, Department of Trauma Surgery, Medical University of Vienna, Austria.

Results

The mean age was 33.8 years (range 0–97), 2620 (49.9 %) were male and 2628 (50.1 %) were female individuals. In our study population, a total of 2530 dog bites (48.2 %), 930 cat bites (17.8 %), 357 other animal bites (6.8 %), 426 human bites (8.1 %) and 1005 human self-bites (19.2 %) have been observed. A total of 995 wounds (19.0 %) have been infected. Surgery was done in 132 wounds (2.5 %).

Conclusion

We could show a six times higher infection rate of cat bites compared to dog bites. Human bites showed a total infection rate of 8.2 %. Observed infection rate of puncture wounds and wounds greater than 3 cm was 1.5 times higher than for all other wounds in the present study. Total infection rates within 24 h to antibiotic administration was 29.3 %, compared to 65.0 % < 48 h and 81.1 % < 72 h. Time interval also influenced the overall outcome showing a 2.6 increase in acceptable and 1.3 increase in poor outcome after 72 h.

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Acknowledgments

FM Kovar wants to give eminent credit to his parents and friends for their unlimited support for his research, and when the sun was not shining. Special thanks to TN, CG and SA to encourage him to go ahead during some rocky times in the past years.

Conflict of interest

The data collection for the present article was funded by a grant from VFUO (Verein zur Förderung der Forschung auf dem Gebiet der Unfallchirurgie und Orthopädie) with 2000 €. We hereby certify that there are no actual or potential conflicts of interest for the authors of the present article. There are no undisclosed financial or personal relationships with other people or organisations that could inappropriately influence our work.

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Authors and Affiliations

  1. Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    Manuela Jaindl, Christiane Thallinger & Florian M. Kovar MD

  2. Labors.at, Vienna, Austria

    Gerhard Oberleitner

  3. Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria

    Georg Endler

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  1. Manuela Jaindl
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  2. Gerhard Oberleitner
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  5. Florian M. Kovar MD
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Correspondence to Florian M. Kovar MD.

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Jaindl, M., Oberleitner, G., Endler, G. et al. Management of bite wounds in children and adults—an analysis of over 5000 cases at a level I trauma centre. Wien Klin Wochenschr 128, 367–375 (2016). https://doi.org/10.1007/s00508-015-0900-x

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