Maimaris C, Quinton D N
Accident and Emergency Department, Leicester Royal Infirmary, England.
Arch Emerg Med. 1988 Sep;5(3):156-61. doi: 10.1136/emj.5.3.156.
Dog-bite wounds are often left open because of their reputation for infection if primarily closed. A prospective randomized trial comparing primary closure with leaving the wound open was performed to assess infection and cosmesis. Ninety-six patients with 169 lacerations had thorough surgical debridement and irrigation of their wounds. Ninety-two wounds were sutured and 77 left open. No prophylactic antibiotics were given. A total of 13 wounds developed infection: seven sutured and six unsutured wounds (not statistically significant), giving an overall infection rate of 7.7%. Significantly (P less than 0.01), more wound infections occurred in the hand in both groups compared to the rest of the body, indicating that particular attention should be paid to management of such wounds. It was concluded that dog-bite wounds should receive thorough surgical treatment and can be safely sutured at presentation. Special care should be given to hand wounds.
由于人们认为犬咬伤伤口如一期缝合会有感染风险,所以通常予以开放处理。开展了一项前瞻性随机试验,比较一期缝合与伤口开放处理,以评估感染情况及美观效果。96例患者的169处裂伤均接受了彻底的外科清创和伤口冲洗。92处伤口进行了缝合,77处伤口保持开放。未给予预防性抗生素。共有13处伤口发生感染:7处缝合伤口和6处未缝合伤口(无统计学意义),总体感染率为7.7%。两组中手部伤口感染明显多于身体其他部位(P小于0.01),这表明对此类伤口的处理应格外注意。得出的结论是,犬咬伤伤口应接受彻底的外科治疗,就诊时可安全地进行缝合。手部伤口应给予特别护理。