Garvey Erin M, Twitchell Denice K, Ragar Rebecca, Egan John C, Jamshidi Ramin
Division of General Surgery, The Mayo Clinic, 5777 E Mayo Blvd., Phoenix, AZ 85255, USA.
Pediatric Surgery, Phoenix Children's Hospital, 1920 E Cambridge Ave., Phoenix, AZ 85006, USA.
J Pediatr Surg. 2015 Feb;50(2):343-6. doi: 10.1016/j.jpedsurg.2014.09.051. Epub 2014 Dec 26.
Pediatric dog bite injuries are common and vary in severity. We sought to characterize predisposing factors, required interventions, and morbidity.
A prospective clinical database at a level one pediatric trauma center was reviewed for dog bite injuries over 74 consecutive months ending December 2013. This included all patients brought in by ambulance and/or seen by the trauma team.
Of 650 dog bite incidents, 282 met the criteria for inclusion in the trauma database. Median age was 5 years (range, 2 months to 17 years) and 55% (154/282) of patients were male. Pit bulls were most frequently responsible, accounting for 39% (83/213) of incidents in which dog breed was documented. Fifty-three percent (150/282) of dogs belonged to the patient's immediate or extended family. Sixty-nine percent (194/282) of patients required operative intervention: 76% laceration repairs, 14% tissue transfers, and 2% neurosurgical interventions. The most severe injuries were depressed skull fractures, intracranial hemorrhage, laryngotracheal transection, and bilateral orchiectomy. Median length of stay was 1 day (range, 0 to 25 days). There were no mortalities.
Pediatric dog bites span a wide range of ages, frequently require operative intervention, and can cause severe morbidity. Dog familiarity did not confer safety, and in this series, Pit bulls were most frequently responsible. These findings have great relevance for child safety.
Pediatric dog bites are common and can vary in severity from superficial wounds to life-threatening injuries. Dog familiarity may confer a false sense of safety. A national dog bite prevention and education campaign should be developed with the goal of decreasing the incidence of pediatric dog bites.
儿童犬咬伤很常见，严重程度各异。我们旨在确定诱发因素、所需干预措施及发病率。
回顾了一家一级儿童创伤中心连续74个月（截至2013年12月）的犬咬伤前瞻性临床数据库。这包括所有由救护车送来和/或创伤团队诊治的患者。
在650起犬咬伤事件中，282起符合纳入创伤数据库的标准。中位年龄为5岁（范围为2个月至17岁），55%（154/282）的患者为男性。比特犬造成的咬伤最为常见，在记录犬种的事件中占39%（83/213）。53%（150/282）的犬属于患者的直系或旁系亲属。69%（194/282）的患者需要手术干预：76%为伤口缝合，14%为组织移植，2%为神经外科干预。最严重的损伤为颅骨凹陷性骨折、颅内出血、喉气管横断和双侧睾丸切除。中位住院时间为1天（范围为0至25天）。无死亡病例。
儿童犬咬伤涉及广泛年龄范围，常需手术干预，且可导致严重发病。熟悉犬并不能确保安全，在本系列中，比特犬造成的咬伤最为常见。这些发现对儿童安全具有重要意义。
儿童犬咬伤很常见，严重程度从浅表伤口到危及生命的损伤不等。熟悉犬可能会带来错误的安全感。应开展全国性的犬咬伤预防和教育活动，以降低儿童犬咬伤的发生率。
