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儿科三级创伤中心的狗咬伤处理经验。

A Pediatric Level III Trauma Center Experience With Dog Bite Injuries.

机构信息

University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.

Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA.

出版信息

Clin Pediatr (Phila). 2024 Jul;63(7):914-920. doi: 10.1177/00099228231200097. Epub 2023 Sep 13.

Abstract

Dog bite injuries often present to Emergency Departments (ED), and between 2001 and 2003, approximately 4.5 million adults and children were injured. Injuries may range from puncture wounds to deep tissue lacerations or avulsions. Deaths have been described. Our objective was to describe dog bite injuries, the overall location of injuries, and need for vaccination among children who presented to a Pediatric ED designated as a level III trauma center with a robust facial surgical infrastructure. This was a 6-year retrospective study. Charts were identified by () codes for lacerations or injuries secondary to animal bites and accessing the hospital's trauma database. Variables abstracted were age, sex, type of injury, location, need for antibiotics, immunization states and requirement of tetanus or rabies vaccine, disposition from ED to the operating room, home, or any in-patient unit. We excluded children older than 17 years of age and children who had a post-bite injury infection or injury not initially managed in our facility or medical system. The final cohort consisted of 152 children. The median age was 52 months and age ranged from 2 to 215 months. Children with a single bite injury were older when compared with those with numerous injuries, 81 and 62 months of age, respectively. Among young children, 75% of injuries occurred above the neck and 15.1% were managed in the operating room. Twenty-four percent of children required either a tetanus or rabies vaccination. Most dog bite injuries occurred to facial structures. Comprehensive care of dog victims included awareness of both dog and injured child vaccination status.

摘要

狗咬伤常就诊于急诊科(ED),2001 年至 2003 年期间,约有 450 万儿童和成人受伤。损伤范围从穿刺伤到深部组织撕裂或撕脱伤不等。有死亡病例的报道。我们的目的是描述就诊于被指定为三级创伤中心的儿科 ED 的儿童的狗咬伤、总体损伤部位和疫苗接种需求,该儿科 ED 拥有完善的面部外科基础设施。这是一项为期 6 年的回顾性研究。通过 () 代码识别外伤或动物咬伤的裂伤或损伤,并访问医院的创伤数据库。提取的变量包括年龄、性别、损伤类型、部位、是否需要抗生素、免疫状态和破伤风或狂犬病疫苗的需求、从 ED 到手术室、家庭或任何住院病房的处置情况。我们排除了 17 岁以上的儿童以及在我们的医疗机构或医疗系统中发生咬伤后感染或损伤未得到初始处理的儿童。最终队列包括 152 名儿童。中位年龄为 52 个月,年龄范围为 2 至 215 个月。与多处损伤的儿童相比,单一咬伤损伤的儿童年龄较大,分别为 81 和 62 个月。在幼儿中,75%的损伤发生在颈部以上,15.1%在手术室处理。24%的儿童需要接种破伤风或狂犬病疫苗。大多数狗咬伤发生在面部结构。狗受害者的全面护理包括了解狗和受伤儿童的疫苗接种状况。

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