Treatment of facial dog bite injuries in children: A retrospective study

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Abstract

Purpose: The authors assess their approach to immediate surgical repair with general anesthesia of facial dog bites in children over a 10-year period in their pediatric department. Methods: The authors reviewed a series of 100 children (59 boys, 41 girls) who required immediate surgical intervention during the first hours after admission between 1985 and 1995. Strict disinfection was always used to preclude the risk of rabies, and parenteral antibiotherapy was used to avoid aero-anaerobic infections. Results: A total of 68% of children were below 5 years of age. The most frequent injury was to the midface. Associated injuries or death were not observed. One case of postoperative wound infection was noted. Four surgical revisions were performed because of unsightly scars, but in most children the scar had attenuated 1 year after injury. Conclusions: The aim of immediate surgical repair is to obtain a satisfactory cosmetic result and to avoid infections. Better cosmetic results (4 cases of scar revisions) with a minimal risk of wound infections (1 cheek wound infection) are obtained. J Pediatr Surg 35:580-583. Copyright © 2000 by W.B. Saunders Company.

Section snippets

Materials and methods

We reviewed 100 children (59 boys, 41 girls) treated between 1985 and 1995 representing 143 bites. There were 68 patients younger than 5 years, 25 patients between 5 and 10 years, and 7 patients between 10 and 15 years old.

Initial examination aimed to detect associated lesions such as neurological (extradural hematoma, craniocerebral), ophthalmic (orbital), orthopedic (cervical spine), and thoracoabdominal wounds. Search for bone injuries was systematic. Because of the legal implications,

Results

The distribution of severity of dog bites was as follows: stage 1, 84 wounds (59% of cases); stage 2, 50 wounds (35% of cases); and stage 3, 9 wounds (6% of cases).

Discussion

Dog bites are an important health care problem and a common cause of trauma to the face in children. In the United States the occurrence of dog bites is estimated to range from 300 to 700 bites per 100,000 people per year, and 30% of these concern children.1 In France, there are 9 million dogs, and 30% of families possess one.2

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Address reprint requests to Dr Jiad N. Mcheik, MD, 9 Allée des conviviales. Res. Les fontaniles, appt. 104. 33700 Merignac, France.

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