Department of Trauma Surgery, Medical University of Vienna, Austria.
Injury. 2012 Dec;43(12):2117-21. doi: 10.1016/j.injury.2012.04.016. Epub 2012 May 16.
Animal bite wounds are a significant problem, which have caused several preventable child deaths in clinical practice in the past. The majority of bite wounds is caused by dogs and cats, and also humans have to be considered to lead to those extreme complicated diagnosis in the paediatric patient population. Early estimation of infection risk, adequate antibiotic therapy and, if indicated, surgical treatment, are cornerstones of successful cures of bite wounds. However, antibiotic prophylaxis and wound management are discussed controversially in the current literature. In our study, we retrospectively investigated the bite source, infection risk and treatment options of paediatric bite wounds.
A total of 1592 paediatric trauma patients were analysed over a period of 19 years in this retrospective study at a level I trauma centre, Department of Trauma Surgery, Medical University of Vienna, Austria. Data for this study were obtained from our electronic patient records and follow-up visits. In our database, all paediatric patients triaged to our major urban trauma centre have been entered retrospectively.
During the 19-year study period, 1592 paediatric trauma patients met the inclusion criteria. The mean age was 7.7 years (range 0-18.9), 878 (55.2%) were males and 714 (44.8%) were females. In our study population, a total of 698 dog bites (43.8%), 694 human bites (43.6%), 138 other bites (8.7%) and 62 cat bites (3.9%) have been observed. A total of 171 wounds (10.7%) have been infected. Surgical intervention was done in 27 wounds (1.7%).
Gender-related incidence in bite wounds for dog and cat could be detected. Second, our findings for originator of bite wounds reflect the findings in the published literature. Total infection rate reached 10.7%, primary antibiotic therapy was administered in 221 cases (13.9%) and secondary antibiotic therapy in 20 (1.3%) cases. Observed infection rate of punctured wounds and wounds greater than 3 cm was 3 times higher than for all other wounds. Our findings need to be proven in further prospective clinical trials.
动物咬伤是一个严重的问题，在过去的临床实践中已经导致了几例可预防的儿童死亡。大多数咬伤是由狗和猫引起的，也必须考虑到人类，因为在儿科患者群体中，这些咬伤可能导致极端复杂的诊断。早期评估感染风险、充分的抗生素治疗以及在必要时进行手术治疗，是成功治愈咬伤的关键。然而，抗生素预防和伤口管理在当前文献中存在争议。在我们的研究中，我们回顾性调查了儿科咬伤的咬伤源、感染风险和治疗选择。
在这项回顾性研究中，我们对 19 年来在奥地利维也纳医科大学创伤外科一级创伤中心接受治疗的 1592 例儿科创伤患者进行了分析。本研究的数据来自我们的电子病历和随访。在我们的数据库中，所有分诊到我们主要城市创伤中心的儿科患者都被回顾性地录入。
在 19 年的研究期间，符合纳入标准的儿科创伤患者共有 1592 例。平均年龄为 7.7 岁（范围 0-18.9），男性 878 例（55.2%），女性 714 例（44.8%）。在我们的研究人群中，共有 698 例狗咬伤（43.8%）、694 例人咬伤（43.6%）、138 例其他咬伤（8.7%）和 62 例猫咬伤（3.9%）。共有 171 例（10.7%）伤口感染。进行了 27 例（1.7%）手术干预。
可以检测到与性别相关的狗和猫咬伤的发生率。其次，我们关于咬伤源的发现反映了已发表文献中的发现。总感染率为 10.7%，221 例（13.9%）患者接受了初级抗生素治疗，20 例（1.3%）患者接受了二级抗生素治疗。观察到穿刺伤和大于 3cm 的伤口的感染率是所有其他伤口的 3 倍。我们的发现需要在进一步的前瞻性临床试验中得到证实。
