Piccart Frederik, Dormaar Jakob Titiaan, Coropciuc Ruxandra, Schoenaers Joseph, Bila Michel, Politis Constantinus
Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium.
Craniomaxillofac Trauma Reconstr. 2019 Sep;12(3):199-204. doi: 10.1055/s-0038-1660441. Epub 2018 Jun 22.
Dog bite-related wounds seem to have become a common problem, especially when they relate to the head and neck region. According to Overall and Love, up to 18 per 1,000 people sustain a dog bite every year, of whom 3 need medical attention. Approximately 1 to 2% of bite injuries require hospitalization of the victims. Most of the lacerations are found in the upper lip and the nose regions and they are classified according to severity and concomitant damage to other organs. Bite wounds are considered "dirty" wounds and are prone to infection. When dealing with bite wounds, there is always an indication for antibiotic treatment. Broad-spectrum antibiotics like amoxicillin-clavulanate and/or moxifloxacin cover most of the pathogenic flora and should be administered in every bite wound case at risk of infection. This article would like to present a medical record review: a retrospective analysis of all bite wounds sustained in the head and neck region, treated at the University Hospital of Leuven over the past 20 years. Furthermore, it provides an overview of the current literature and its standings on the treatment of dog bite injuries in the maxillofacial region. We assessed both surgical and medical treatment options, as well as primary management, which includes infection prevention strategies, closure management, and additional vaccination requirements. Secondary management or scar revision methods will be mentioned. After conducting a UZ Leuven database search using keywords such as "dog," "dog bite," "face," "head," "lip," and others, 223 patients were included. Age at the time of injury, location of the injury, treatment method used, and whether secondary infection was present or not were documented. All patients have been divided in age groups. We concluded that 21.52% was 5 years old or younger. Almost half of our patients (49.33%) were 18 years old or younger. Of all patients, 79 were hospitalized (35.43%). Primary closure was the treatment of choice. In 141 patients, the wounds were closed primarily (63.23%), resulting in only 2.24% reported secondary infections. Only one fatality was reported in our center over the course of 20 years (0.45%), a 6-year-old girl who had been attacked by her father's Rottweilers. Most patients who sustained dog bite injuries in the head and neck region seem to be children, specifically toddlers. Due to their height, it is possible they are more prone to dog bite injuries in the head and neck region. It is essential to optimize management of these injuries due to the impact they have on patients. This article provides the epidemiological data and clinical outcome of the approach at our center.
与狗咬伤相关的伤口似乎已成为一个常见问题，尤其是涉及头颈部区域时。据奥弗拉尔和洛夫称，每年每1000人中多达18人会被狗咬伤，其中3人需要医疗救治。约1%至2%的咬伤需要受害者住院治疗。大多数撕裂伤见于上唇和鼻部区域，并根据严重程度以及对其他器官的伴随损伤进行分类。咬伤伤口被视为“污染”伤口，容易感染。处理咬伤伤口时，始终需要使用抗生素治疗。像阿莫西林-克拉维酸和/或莫西沙星这样的广谱抗生素能覆盖大多数致病菌群，应在每例有感染风险的咬伤伤口病例中使用。本文将呈现一份病历回顾：对过去20年在鲁汶大学医院接受治疗的所有头颈部咬伤伤口进行的回顾性分析。此外，还概述了当前关于颌面部狗咬伤治疗的文献及其现状。我们评估了手术和药物治疗方案以及初始处理，包括感染预防策略、伤口缝合处理和额外的疫苗接种要求。还将提及二期处理或瘢痕修复方法。在使用“狗”“狗咬伤”“面部”“头部”“嘴唇”等关键词对鲁汶大学医院数据库进行搜索后，纳入了223例患者。记录了受伤时的年龄、受伤部位、使用的治疗方法以及是否存在继发感染。所有患者按年龄分组。我们得出结论，21.52%的患者年龄在5岁及以下。几乎一半的患者（49.33%）年龄在18岁及以下。所有患者中有79人住院（35.43%）。一期缝合是首选治疗方法。141例患者伤口进行了一期缝合（63.23%），继发感染报告率仅为2.24%。在我们中心20年的时间里仅报告1例死亡（0.45%），是一名6岁女孩，被她父亲的罗威纳犬袭击。大多数头颈部遭受狗咬伤的患者似乎是儿童，尤其是幼儿。由于他们的身高，他们可能更易在头颈部区域被狗咬伤。鉴于这些损伤对患者的影响，优化这些损伤的处理至关重要。本文提供了我们中心治疗方法的流行病学数据和临床结果。
