Hersant B, Cassier S, Constantinescu G, Gavelle P, Vazquez M-P, Picard A, Kadlub N
Service de chirurgie maxillofaciale et plastique, hôpital d'enfants Armand-Trousseau, UFR Pierre-et-Marie-Curie, université Pierre-et-Marie-Curie-Paris-6, AP-HP, 26 avenue du Docteur-Arnold-Netter, Paris, France.
Ann Chir Plast Esthet. 2012 Jun;57(3):230-9. doi: 10.1016/j.anplas.2011.11.003. Epub 2011 Dec 21.
The face is the area most vulnerable for dog bites in children. Surgical management is an emergency to prevent infection, functional and aesthetic outcomes. The aim of this study was to define a new gravity scale, and to determine a prevention policy.
In our maxillofacial and plastic surgery department, we conducted a retrospective study from 2002 to 2010, including 77 children under 16 years old, victims of facial dog bite. We analyzed epidemiological, clinical data, surgical outcomes.
The mean age was 5.36 years. Dogs were principally represented by class I and II dogs; 27,7% of them had ever bitten before. In almost all the cases, the dogs belong to the family or closers. Twenty-one percent of children belong to an unfavourable social environment; 71.43% of dog bites interested the central area of the face. The bites were deep in 77% of cases with amputation or extensive loss of substance in 31% of cases. The healing time was 10.54 months. Nearly a third of patients required several surgeries; 41.56% of patients had aesthetic and functional sequelae; 35.1% of children had psychological problems afterward.
Facial children dog bites require a multidisciplinary approach, and a long-term follow-up. We propose a new classification of dog bite severity, more appropriate to the face.
面部是儿童最易被狗咬伤的部位。手术治疗是预防感染、确保功能和美观效果的紧急措施。本研究的目的是定义一种新的严重程度分级标准,并确定预防策略。
在我们的颌面整形外科,我们对2002年至2010年期间77名16岁以下面部被狗咬伤的儿童进行了回顾性研究。我们分析了流行病学、临床数据及手术结果。
平均年龄为5.36岁。狗主要为I级和II级;其中27.7%曾有过咬人记录。几乎所有情况下,狗都属于家庭或关系亲近者。21%的儿童处于不利的社会环境;71.43%的狗咬伤发生在面部中央区域。77%的咬伤较深,31%的病例有截肢或大面积组织缺损。愈合时间为10.54个月。近三分之一的患者需要多次手术;41.56%的患者有美学和功能后遗症;35.1%的儿童之后出现心理问题。
儿童面部狗咬伤需要多学科方法及长期随访。我们提出一种新的狗咬伤严重程度分类,更适用于面部。