Correira Kristine
Worcester Medical Center Emergency Department, Quinsigamond Community College, Worcester, Mass., USA.
JAAPA. 2003 Apr;16(4):28-32, 34, 37.
All bite wounds require the same general approach regarding history and physical exam, selective ancillary testing, wound cleaning, and immobilization. Primary closure should be considered only for bites in which the concerns about cosmetic outcome outweigh the risk of infection. Antibiotic prophylaxis should be initiated for patients with high-risk bite wounds and for those who are at risk for serious wound infection complications. The chosen antibiotic should cover beta-lactamase-producing aerobic and anaerobic organisms, including Pasteurella species in animal bites and E corrodens in human bites.
所有咬伤伤口在病史和体格检查、选择性辅助检查、伤口清洁及固定方面都需要相同的一般处理方法。仅当对美容效果的担忧超过感染风险时,才应考虑一期缝合。对于有高危咬伤伤口的患者以及有发生严重伤口感染并发症风险的患者,应开始预防性使用抗生素。所选抗生素应覆盖产β-内酰胺酶的需氧菌和厌氧菌,包括动物咬伤中的巴斯德菌属以及人咬伤中的啮蚀艾肯菌。