Surgical treatment of mammalian bites----experience in the management of facial wounds by dog and cat bite in China.

Abstract

Mammalian bites to the face challenges not only related to wound healing but also to aesthetic outcomes. This study aims to summarize 7 years of experience in treating mammalian bite wounds and propose a surgical approach for managing these wounds. From July 2016 to August 2023, 185 cases were treated and retrospectively evaluated. Variables collected included age, gender, anatomical location, wound features, and treatment management. The postoperative results were reviewed and analyzed. Of the 185 patients, 27.57% were under 18 years of age; with dog bites accounting for approximately 89.19% of cases. Notably, 59.46% of the injuries occurred in females. The most common injury sites were the forehead, chin, and cheek. Primary closure was utilized for 96.22% of the wounds. The fatty areas, such as the cheek, parotid gland, and mandibular region, were identified as high-risk areas for bite infections. In contrast, the forehead, periocular, nose, ear, and lip were classified as low-risk areas, while other regions were considered moderate-risk zones. The infection rates post-primary closure for high, moderate and low-risk areas are 9.09%, 6.67%, and 2.56%, respectively. Complex mammalian bite wounds should receive prompt plastic and reconstructive surgical treatment at a tertiary center. Most wounds can be effectively repaired with primary closure and other plastic techniques. Special attention should be given to high-risk bite wounds to prevent infection. This paper provides essential considerations and recommendations for the medical and surgical management of patients presenting with bite injuries.