Dog bites are increasing in frequency and severity - a sustained effect following the COVID-19 pandemic.

The COVID-19 pandemic and subsequent lockdown measures have changed various aspects of society, including patterns of human-animal interactions. This audit investigates the incidence and severity of dog bites admitted under the plastic surgery department at a major trauma centre before and after COVID-19 lockdowns. We assessed trends in dog bite cases over the course of one year (2018) prior to the COVID-19 lockdown and one year after (2022). A time period during COVID-19 lockdown itself was not included to avoid confounding factors due to changes in healthcare provision during the pandemic. Our analysis reveals a 47 % increase in dog bites after lockdowns ended compared to before. We also demonstrate statistically significant increases in the need for operative management (90 % of patients compared to 78 %) and length of inpatient hospital stay (average 63 h compared to 51). Moreover we show that dog bites have increased in severity, with a clear increase in patients presenting with deeper tissue injuries, tissue loss and muscle, nerve, vascular or bone involvement. This represents a significant functional, cosmetic and psychological impact for patients as well as financial impact on the NHS and increased workload for plastic surgery departments. This is the first paper to examine the severity of dog bite injuries and to demonstrate a sustained effect even after the easing of lockdown measures. Our findings shed light on the potential impact of lockdown measures on human-dog interactions and highlight the importance of public awareness and prevention strategies in mitigating dog bites. LAY SUMMARY: Our study demonstrates that dog bite injuries increased in frequency by 47 % following COVID-19 lockdowns. Patients with dog bites are also being admitted for longer than before, requiring more operations and have more severe injuries, with some requiring skin grafting, nerve repair or more complex plastic surgery reconstruction.