Jaindl Manuela, Oberleitner Gerhard, Endler Georg, Thallinger Christiane, Kovar Florian M
Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Labors.at, Vienna, Austria.
Wien Klin Wochenschr. 2016 May;128(9-10):367-75. doi: 10.1007/s00508-015-0900-x. Epub 2015 Dec 11.
Bite wounds are among the commonest types of trauma to which man is the subject. They account for 5 % of the total traumatic wounds evaluated in the emergency department (ED) and approximately 1 % of all the ED visits. Early estimation of infection risk, adequate antibiotic therapy and if indicated surgical treatment are the cornerstones of successful cure of bite wounds.
A total of 5248 consecutive trauma patients were collected prospectively and analysed retrospectively over a period of 15 years in this study at a level I trauma centre, Department of Trauma Surgery, Medical University of Vienna, Austria.
The mean age was 33.8 years (range 0-97), 2620 (49.9 %) were male and 2628 (50.1 %) were female individuals. In our study population, a total of 2530 dog bites (48.2 %), 930 cat bites (17.8 %), 357 other animal bites (6.8 %), 426 human bites (8.1 %) and 1005 human self-bites (19.2 %) have been observed. A total of 995 wounds (19.0 %) have been infected. Surgery was done in 132 wounds (2.5 %).
We could show a six times higher infection rate of cat bites compared to dog bites. Human bites showed a total infection rate of 8.2 %. Observed infection rate of puncture wounds and wounds greater than 3 cm was 1.5 times higher than for all other wounds in the present study. Total infection rates within 24 h to antibiotic administration was 29.3 %, compared to 65.0 % < 48 h and 81.1 % < 72 h. Time interval also influenced the overall outcome showing a 2.6 increase in acceptable and 1.3 increase in poor outcome after 72 h.
咬伤是人类最常见的创伤类型之一。在急诊科评估的所有创伤性伤口中，咬伤占5%，约占急诊科所有就诊病例的1%。早期评估感染风险、进行充分的抗生素治疗以及必要时进行手术治疗是成功治愈咬伤的基石。
本研究在奥地利维也纳医科大学创伤外科一级创伤中心，对15年间前瞻性收集并回顾性分析的5248例连续创伤患者进行了研究。
平均年龄为33.8岁（范围0 - 97岁），男性2620例（49.9%），女性2628例（50.1%）。在我们的研究人群中，共观察到2530例狗咬伤（48.2%）、930例猫咬伤（17.8%）、357例其他动物咬伤（6.8%）、426例人咬伤（8.1%）和1005例人类自我咬伤（19.2%）。共有995处伤口（19.0%）发生感染。132处伤口（2.5%）接受了手术治疗。
我们发现猫咬伤的感染率比狗咬伤高六倍。人咬伤的总感染率为8.2%。在本研究中，观察到的刺伤和大于3厘米伤口的感染率比所有其他伤口高1.5倍。抗生素给药后24小时内的总感染率为29.3%，相比之下，48小时内为65.0%，72小时内为81.1%。时间间隔也影响了总体结果，72小时后可接受结果增加了2.6倍，不良结果增加了1.3倍。
