Mammalian bites. Rational approach to management.

When a mammal's bite breaks the skin, aggressive management is indicated to prevent infection and provide for a good cosmetic and functional result. Vigorous irrigation and thorough debridement play a more important role than antibiotics in preventing infection. Whether antibiotics have prophylactic value in this situation remains controversial, but semisynthetic penicillins or cephalosporins may be worth a try in high-risk cases. Suturing may or may not be advisable, depending on cosmetic considerations and risk of infection. Prophylaxis against tetanus is a must, and hepatitis and rabies prophylaxis may also be necessary in selected cases.