Tabbara Malek, Hatzigianni Panagiota, Fux Christoph, Zimmermann Heinz, Exadaktylos Aristomenis K
Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern, Switzerland; email:
Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Wounds. 2012 Apr;24(4):85-90.
Human bites (HB) are the third most common bite wound diagnosed in emergency departments, after dog and cat bites. Management of HB can be challenging, given the high risk of infection associated with multiorganism-rich oral flora. Recognition and early aggressive treatment are essential steps in preventing infections and other associated complications.
A retrospective, 10-year electronic chart review was performed, which identified 104 HB. Diagnosis, treatment, and outcome were noted for each case.
Most of the patients were male, with a male:female ratio of 4:1. A majority of patients (n = 53, 51%) presented with finger and hand injuries. Only 13.8% were bitten on the head or neck, and 25% on the upper limbs. The remainder (35.2%) of patients sustained injuries to other body parts. Twelve operations were necessary and performed by plastic and hand surgeons. More than half of the patients (60.5%) received antibiotic therapy, and 84.6% of the patients had their tetanus prophylaxis administered or received a booster by the time of treatment. Only 40.4% of patients had a post-bite serology test to rule out bloodborne viral infections, none of whom tested positive. The viral status of the biter was known in two cases.
The goals of HB management are to minimize infection risk and its complications, and to prevent the transmission of systemic infections, such as hepatitis B/C and HIV. Accurate documentation and a management algorithm should be instituted in emergency departments in order to achieve these goals. .
人类咬伤(HB)是急诊科诊断出的第三常见咬伤伤口,仅次于狗咬伤和猫咬伤。鉴于与富含多种微生物的口腔菌群相关的高感染风险,人类咬伤的处理可能具有挑战性。识别和早期积极治疗是预防感染及其他相关并发症的关键步骤。
进行了一项为期10年的回顾性电子病历审查,确定了104例人类咬伤病例。记录了每个病例的诊断、治疗和结果。
大多数患者为男性,男女比例为4:1。大多数患者(n = 53,51%)表现为手指和手部受伤。仅13.8%的患者头部或颈部被咬伤,25%的患者上肢被咬伤。其余患者(35.2%)身体其他部位受伤。有12例手术由整形外科医生和手外科医生进行。超过一半的患者(60.5%)接受了抗生素治疗,84.6%的患者在治疗时接受了破伤风预防或加强注射。只有40.4%的患者进行了咬伤后血清学检测以排除血源病毒感染,无一例检测呈阳性。已知咬人者病毒感染状况的有两例。
人类咬伤处理的目标是将感染风险及其并发症降至最低,并防止乙型/丙型肝炎和艾滋病毒等全身性感染的传播。急诊科应建立准确的记录和处理流程以实现这些目标。