OBJECTIVES: The management of dog bite wounds is controversial, and current data on risk of infection are variable and inconsistent. Furthermore, the use of prophylactic or empiric antibiotics for the treatment of these wounds is debatable. We investigate the rate of wound infections and other complications after primary repair of pediatric facial dog bite injuries. METHODS: We reviewed 87 consecutive patients aged 18 years or younger who had facial dog bite injuries from January 2003 to December 2008. Variables examined were age, sex, setting of repair, number of sutures used for repair, whether surgical drains were used, and antibiotic administration. End points measured were incidence of wound infection, need for scar revision, and any wound complications. RESULTS: The mean age of patients was 6.8 years, and the majority were women (53%). All facial injuries were primarily repaired at the time of presentation either in the emergency department (ED; 46%), operating room (OR; 51%), or an outpatient setting (3%). All patients received an antibiotic course, none of the patients developed wound infection, and no subsequent scar revisions were performed. Three patients repaired in the OR underwent placement of a total of 4 closed-suction drains. The mean (SD) age of patients repaired in the OR was significantly younger than those repaired in the ED (5.7 [3.9] vs 8.0 [4.5] years, respectively; P < 0.01). The number of sutures used were greater for patients repaired in the OR than in the ED (66.4 [39.6] vs 21.7 [12.5], respectively; P < 0.01). CONCLUSIONS: Intuitively, younger patients and patients with greater severity injuries are more likely to undergo repair in the OR, and this was supported by our data. Overall, we found that primary repair of pediatric facial dog bite injuries, including complex soft-tissue injuries, is safe when performed in conjunction with antibiotic administration; however, further cross-specialty studies are needed to fully characterize these end points in a larger population.
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机译：目的：狗咬伤的处理尚存争议，有关感染风险的最新数据也不尽相同。此外，使用预防性或经验性抗生素治疗这些伤口是有争议的。我们调查了儿童面部狗咬伤的初步修复后伤口感染和其他并发症的发生率。方法：我们回顾了2003年1月至2008年12月连续87例18岁以下的面部狗咬伤的患者。检查的变量包括年龄，性别，修复设置，用于修复的缝合线数量，是否使用了外科引流管，以及抗生素管理。测量的终点是伤口感染的发生率，是否需要修复疤痕以及任何伤口并发症。结果：患者的平均年龄为6.8岁，大多数为女性（53％）。在就诊时，所有面部损伤均在急诊科（ED; 46％），手术室（OR; 51％）或门诊（3％）中得到了初步修复。所有患者均接受了抗生素疗程，没有患者出现伤口感染，也没有进行后续的疤痕修复。手术室中有3例修复的患者总共放置了4条闭吸引流管。在手术室中修复的患者的平均（SD）年龄比在ED中修复的患者显着年轻（分别为5.7 [3.9] vs 8.0 [4.5]岁; P <0.01）。在手术室中修复的患者使用的缝合线数量比在急诊室中的要多（分别为66.4 [39.6]和21.7 [12.5]; P <0.01）。结论：直观上，年轻患者和严重程度更高的患者更有可能接受手术修复，这得到了我们的数据的支持。总的来说，我们发现结合抗生素给药进行小儿面部狗咬伤的初步修复是安全的，包括复杂的软组织损伤。但是，需要进一步的跨专业研究来充分表征较大人群中的这些终点。
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