ANIMAL BITES AND STINGS

Clinical features

  • Teeth marks or scratches, lacerations
  • Puncture wounds (especially cats)
  • Complications: bleeding, lesions of deep structures, wound infection (by mixed flora, anaerobs), tissue necrosis, transmission of diseases (tetanus, rabies, others)

MANAGEMENT

First aid

  • Immediately clean the wound thoroughly with plenty of clean water and soap to remove any dirt or foreign bodies
  • Stop excessive bleeding where necessary by applying pressure
  • Rinse the wound and allow to dry
  • Apply an antiseptic: Chlorhexidine solution 0.05% or povidone iodine solution 10%
  • Soak punture wounds in antiseptic for 15 minutes
  • Thorough cleaning, exploration and debridement (under local anesthesia if possible)

As a general rule

DO NOT SUTURE BITE WOUNDS

  • Refer wounds on hands and face, deep wounds, wounds with tissue defects to hospital for surgical management

Tetanus prophylaxis

  • Give TT immunisation (tetanus toxoid, TT 0.5 ml) if not previously immunised within the last 10 years

Prophylactic antibiotics

  • Indicated in the following situations:
    • Deep puncture wounds (especially Cats)
    • Human bites
    • Severe (deep, extensive) wounds
    • Wounds on face, genitalia, hands
    • Wounds in immunicompromised hosts
  • Amoxicillin 500 mg every 8 hours for 5-7 days
    Child: 15 mg/kg per dose
  • Plus Metronidazole 400 mg every 12 hours
    Child: 10-12.5 mg/kg per dose

Note

  • Do not use routine antibiotics for small uncomplicated
    dog bites/wounds