Animal Bites And Reconstruction

摘要

Animal bites resulting in significant tissue loss poses unique reconstructive challenge. This article reviews management of series of eleven cases of bite wounds with tissue loss and presents treatment guidelines for the same on the basis of the results. Introduction Animal bites have been on the rise with the explosion of human and animal population, accounting for 1 percent of emergency department visits.1, 2 the animal bites with tissue loss present the surgeon with the challenging aesthetic and often functional problems. Though dog bites are the commonest animal bites, often unusual bites by wild and domestic animals occur often resulting in significant tissue loss necessitating reconstruction.We present a series of eleven cases that were mauled by various wild and domestic animals requiring reconstruction. Various reconstructive options from primary closure to flap cover were considered. Patients and Methods We have retrospectively reviewed management and outcome of eleven patients of various bites with tissue loss managed by Plastic Surgery department during August 2003 to February 2005.The details of patient's demographics, biting animal, circumstances of bite injury, duration of injury, location and extent of wound, wound characteristics, local and systemic treatment received was noted. All the patients were evaluated in detail to ascertain full magnitude of the injury. All the injuries were carefully documented. The integrity of all the specialized structures was thoroughly evaluated. All the patients were regularly followed up, complications if any were noted and subsequently assessment for aesthetic and functional outcome was made. Wounds were cultured for bacteriological study in acute cases prior to cleansing.Among the eleven cases studied, 6 patients were males and 5 were females. The age ranged from from 5 years to 60 years. The duration of injury varied from 2 hours to weeks. All the wounds presented with some tissue loss. The animals implicated were – dog(2), jackal (1), horse (2), camel (2), cat (1), bear (1), snake (2) (Table- 1).