Philipsen T E J, Molderez C, Gys T
Dept. of surgery, AZ St. Dimpna, Geel, Belgium.
Acta Chir Belg. 2006 Nov-Dec;106(6):692-5. doi: 10.1080/00015458.2006.11679983.
Domestic animal bites are quite common, but mostly cause minor lesions, for which no medical help is sought. The objective of this study is to define the complications resulting from cat and dog bites that lead to hospital admission. This analysis led to updated guidelines for the treatment of dog and cat bites in humans.
The emergency department (ED) data of our hospital for the year 2004 were retrospectively analysed, seeking patients that presented with bite wounds from either cat or dog. The patient files were reviewed.
34 patients, bitten by cats or dogs, presented to our ED in 2004. 73.5% of them (n = 25) consulted within 24 hours after the bite. In 11 of these patients (44.0%), primary closure of the wound was performed after thorough rinsing and evaluation of the dead space. All these patients were given prophylactic antibiotics. In none of these did the wounds need to be reopened afterwards. Nine patients (26.5%) did not present to the ED until after the day they were bitten. In all these patients, the bite wounds were located on the hand (n = 6) or forearm (n = 3). They all consulted because of complications. The main symptoms were limited and there was painful mobilisation of fingers and wrist, and swelling and redness in the area of the bite wound. Their wounds were thoroughly explored and in 6 of these nine late-presenting patients, a tendon lesion or a purulent flexor tenosynovitis was diagnosed. These six patients needed admission for further management. The mean admission duration was 6 days (range 4 to 10 days). None of the admitted patients showed any signs of limited mobility or disability during follow-up after discharge.
While cat and dog bites often cause minor lesions that can be treated by thorough wound care if presented early, the importance of possible late complications should not be overlooked. Patients that present with the symptoms of tissue infection due to a cat or dog bite should be examined adequately and may need admission. Due to aggressive treatment, we had no serious or disabling complications in our population after discharge.
家畜咬伤颇为常见,但大多造成轻微损伤,因而患者不会寻求医疗帮助。本研究的目的是确定导致住院治疗的猫和狗咬伤所引发的并发症。该分析得出了人类猫和狗咬伤治疗的更新指南。
回顾性分析我院2004年急诊科数据,寻找猫或狗咬伤伤口的患者,并查阅患者病历。
2004年有34例被猫或狗咬伤的患者到我院急诊科就诊。其中73.5%(n = 25)在咬伤后24小时内前来咨询。在这些患者中的11例(44.0%),伤口在彻底冲洗和评估死腔后进行了一期缝合。所有这些患者均接受了预防性抗生素治疗。之后这些患者的伤口均无需再次切开。9例患者(26.5%)直到被咬伤当天之后才到急诊科就诊。所有这些患者的咬伤伤口均位于手部(n = 6)或前臂(n = 3)。他们均因并发症前来咨询。主要症状为手指和手腕活动受限且疼痛,以及咬伤伤口部位肿胀和发红。对他们的伤口进行了彻底探查,在这9例延迟就诊的患者中有6例被诊断为肌腱损伤或化脓性屈指肌腱腱鞘炎。这6例患者需要住院进一步治疗。平均住院时间为6天(范围4至10天)。所有入院患者出院后随访期间均未出现任何活动受限或残疾迹象。
虽然猫和狗咬伤通常造成轻微损伤,若早期就诊可通过彻底的伤口护理进行治疗,但不应忽视可能出现的晚期并发症的重要性。因猫或狗咬伤出现组织感染症状的患者应进行充分检查,可能需要住院治疗。由于积极治疗,我们的患者出院后未出现严重或致残性并发症。