Animal bite injuries to the head: 132 cases

We made a retrospective study of the casenotes of 132 patients with bite injuries who were treated in the departments of craniomaxillofacial surgery in Berlin and Bochum university hospitals. Dogs caused most of the injuries (n = 121, 92%) and the lips were most commonly involved. Nearly half the patients had superficial injuries. More than 70% of the patients presented to the clinic within 6 h after the bite, and developed fewer wound infections than the patients who presented late. A total of 71 patients were given antibiotics for prophylaxis. Patients who were given amoxycillin with clavulanic acid developed no wound infections. Surgical management included cleansing and primary closure of the wound. Infected wounds were closed primarily after insertion of a drain. Wound cultures showed mainly streptococcus. We concluded that antibiotic prophylaxis is essential for several indications and the antibiotic of first choice is amoxycillin–clavulanic acid. Primary wound closure is an approved principle even in infected wounds.