Dog Bite

• Incidence (1)
  • Most common type of hand bite trauma.
  • 69%-90% of all bites
• Mechanism of injury (1,2)
  • High force
  • Significant crush, puncture, avulsion and tear injuries especially with bigger dogs.
  • Likely to cause structural damage to muscles, tendons, nerves and vessels.
• Microbiology (3)
  • Pasteurella multocida, Streptobacillus,Staphylococcus, anaerobes.
    • P. multocida typically presents with a discharging wound 24h post injury.
  • Infection less likely in comparison to cat bites (4% vs 50%)
  • Capnocytophaga canimorsus (in dog saliva) can cause severe sepsis, endocarditis, DIC especially post-splenectomy patients.
  • Rabies
    • Rhabdovirus
    • Consider if bite occurred overseas

GENERAL (4,5):

• Instruct to be nil by mouth
• Remove rings
• Give antibiotics (as per local guidelines)
• Pain relief
• Tetanus prophylaxis (as per local guidelines)

WOUND CARE:

• Washout the wound with running water
  • If painful, consider using local anaesthetic to allow thorough washout
• If there is cellulitis present use a pen marker to draw at the edges for progression assessment.
• Apply a suitable dressing
  • 1^stlayer: non-adherent eg. adaptic or atrauman
  • 2^ndlayer: padding eg. gauze
    • Enough to hold the amount of exudate likely to come from the wound in order to prevent strike through
  • 3^rdlayer: tape/plaster
• Provide a high arm sling
  • Hand should be above the heart

DISCUSS WITH SENIOR:

LIKELY TO REQUIRE ADMISSION