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对南非一家三级医院急诊科收治的犬咬伤患者的审计。

An Audit of Patients with Dog-bite Wounds Presenting to a Tertiary Level Hospital Emergency Department in South Africa.

作者信息

Nkomo Mzamo, Mahomed Zeyn, Laher Abdullah E

机构信息

Emergency Medicine, Tambo Memorial Hospital, Johannesburg, ZAF.

Emergency Medicine, University of the Witwatersrand, Johannesburg, ZAF.

出版信息

Cureus. 2020 Jan 4;12(1):e6558. doi: 10.7759/cureus.6558.

Abstract

Background Dog-bite wounds are a common emergency department (ED) presentation, accounting for approximately 5% of traumatic wounds in the US. However, only 20-50% of patients actually present to the ED for medical attention following a dog-bite wound. Methods This was a transverse, retrospective audit of medical records of patients that had presented to the Tembisa Provincial Academic Hospital ED with dog-bite wounds during the 2014 calendar year. Results Of the 269 patients that were included in the study, 148 (55%) were male. The median age of all study patients was 27 years (range: 3-77 years). Most patients presented between 18h00-24h00 (n = 111, 41.3%). Most wounds were sustained on the lower limbs (n = 80, 68.18%), followed by the upper limbs (n = 74, 28.03%). Patients who were ≤12 years of age had a higher prevalence of buttock/perineum (p = 0.0002) and head/face/neck (p = 0.009) wounds, whereas patients who were >12 years of age had a higher prevalence of lower limb wounds (p = 0.0006). Only 15 (5.6%) wounds were sutured, and antibiotics were prescribed to 120 (45.1%) patients. Tetanus toxoid vaccine (TTV) and the first dose of the rabies vaccine (RV) were administered to 152 (57.4%) and 240 (89.1%) patients, respectively. Conclusion Children are more likely to present with wounds to the head/face/neck or buttock/perineum regions, while adults are more likely to present with wounds to the lower limbs. Proper strategies should be implemented to ensure that clinicians adhere to the current antibiotics protocols as well as rabies and tetanus post-exposure prophylaxis (PEP)-prescribing guidelines.

摘要

背景

犬咬伤伤口是急诊科常见的就诊情况,约占美国创伤性伤口的5%。然而,实际上只有20%-50%的患者在犬咬伤伤口后到急诊科就医。方法:这是一项对2014年全年在滕比萨省立学术医院急诊科因犬咬伤伤口就诊的患者病历进行的横向回顾性审计。结果:纳入研究的269例患者中,148例(55%)为男性。所有研究患者的中位年龄为27岁(范围:3-77岁)。大多数患者在18:00-24:00就诊(n = 111,41.3%)。大多数伤口位于下肢(n = 80,68.18%),其次是上肢(n = 74,28.03%)。年龄≤12岁的患者臀部/会阴部(p = 0.0002)和头/面/颈部(p = 0.009)伤口的患病率较高,而年龄>12岁的患者下肢伤口的患病率较高(p = 0.0006)。仅15例(5.6%)伤口进行了缝合,120例(45.1%)患者开具了抗生素。分别有152例(57.4%)和240例(89.1%)患者接种了破伤风类毒素疫苗(TTV)和第一剂狂犬病疫苗(RV)。结论:儿童更易出现头/面/颈部或臀部/会阴部伤口,而成年人更易出现下肢伤口。应实施适当策略,以确保临床医生遵守当前的抗生素方案以及狂犬病和破伤风暴露后预防(PEP)处方指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1058/6996530/55dbd9da3f38/cureus-0012-00000006558-i01.jpg

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