Shipkov Hristo, Stefanova Penka, Sirakov Vladimir, Stefanov Rumen, Dachev Dimitar, Simeonov Martin, Ivanov Biser, Nenov Momchil
Department of Paediatric Surgery and Division of Plastic and Craniofacial Surgery, St George Hospital , Plovdiv , Bulgaria.
J Plast Surg Hand Surg. 2013 Dec;47(6):467-71. doi: 10.3109/2000656X.2013.783486. Epub 2013 Apr 16.
The aim of this study was to evaluate the acute bite wounds in children treated on an inpatient basis over a 10-year period and the criteria for inpatient treatment. This study comprised all acute mammalian bite injuries in relation to all paediatric bite injuries seen at the Emergency Surgical Department (ESD). Inclusion criteria were: aged between 0-18 years; acute human or animal bite injuries (presenting for the first time); and inpatient treatment. Exclusion criteria were: bite wounds treated elsewhere and referred for complications; bites treated on an outpatient basis referred for complications; and all insect bites. Over 10 years, 12,948 children were seen at the ESD. There were 167 children (0.77%) with mammalian bite wounds. Twelve of them responded to the inclusion criteria. They presented 7.18% of all mammalian bite injuries and 0.09% of all paediatric emergency visits at the ESD. The average age was 3.82 ± 1.63 years (from 1.3-7 years). The time elapsed between the accident to the wound debridement was 118.64 ± 101.39 minutes. There were 10 dogs, one horse, and one rabbit bite. Surgical treatment comprised debridement, saline irrigation, and primary closure or reconstruction. All patients received antibiotics in the postoperative period. The average hospital stay was 5.92 ± 2.39 days. In one case a partial distal flap necrosis occurred. Animal bite injuries treated on an inpatient basis are predominantly dog bites in young children under 10 years of age, with deep, extended, and commonly multiple injuries. Only 7% of paediatric bite injuries require inpatient treatment.
本研究的目的是评估10年间住院治疗的儿童急性咬伤伤口以及住院治疗的标准。本研究涵盖了急诊外科（ESD）所见的所有与儿科咬伤相关的急性哺乳动物咬伤损伤。纳入标准为：年龄在0至18岁之间；急性人或动物咬伤损伤（首次就诊）；以及住院治疗。排除标准为：在其他地方治疗并因并发症转诊的咬伤伤口；门诊治疗并因并发症转诊的咬伤；以及所有昆虫叮咬。在10年期间，ESD共诊治了12948名儿童。其中有167名儿童（0.77%）有哺乳动物咬伤伤口。其中12名符合纳入标准。他们占所有哺乳动物咬伤损伤的7.18%，占ESD所有儿科急诊就诊的0.09%。平均年龄为3.82±1.63岁（1.3至7岁）。从事故发生到伤口清创的时间为118.64±101.39分钟。咬伤动物包括10只狗、1匹马和1只兔子。手术治疗包括清创、盐水冲洗以及一期缝合或重建。所有患者术后均接受抗生素治疗。平均住院时间为5.92±2.39天。有1例发生了远端部分皮瓣坏死。住院治疗的动物咬伤损伤主要是10岁以下幼儿的狗咬伤，伤口深、范围广且通常多处受伤。只有7%的儿科咬伤损伤需要住院治疗。
