Peeples E, Boswick J A, Scott F A
J Trauma. 1980 May;20(5):383-9.
A prospective and retrospective evaluation of 75 patients with hand wounds contaminated by human saliva (35) or animal saliva (40) demonstrates that a program of outpatient management can be sufficient for optimal care in many patients. This series challenges the proposition that hospitalization, radiographs, and surgical debridement are necessary for most such wounds. Sixty-seven per cent did not have surgical intervention and no complications resulted. Ninety-two per cent received antibiotics. Radiographs were obtained only when bony injury or entry into a joint was suspected. Delay in seeking treatment until obvious signs of infection or pain are present is common. Literature review details the anatomic factors important in the natural history and control of these infections, and the changes with respect to modes of treatment for these potentially dangerous wounds. The injury is caused by bites with the hand extended or, in fight-bite wounds, with the metacarpal-phalangeal and interphalangeal joints flexed, allowing deeper penetration and then sealing of the wound when the first is opened. Staphylococcus and Streptococcus are the organisms most frequently found in human bites, and in animal bites; Pasteurella multocida should be considered in dog and cat bites.
对75例手部被人唾液（35例）或动物唾液（40例）污染伤口患者进行的前瞻性和回顾性评估表明，门诊治疗方案对许多患者的最佳护理而言可能就足够了。该系列研究对大多数此类伤口都需要住院、拍摄X光片和进行手术清创的观点提出了挑战。67%的患者未接受手术干预，也未出现并发症。92%的患者接受了抗生素治疗。仅在怀疑有骨损伤或伤口进入关节时才拍摄X光片。直到出现明显感染迹象或疼痛才寻求治疗的情况很常见。文献综述详细阐述了在这些感染的自然病程和控制中重要的解剖学因素，以及针对这些潜在危险伤口的治疗方式的变化。损伤是由于手伸展时被咬，或者在斗殴咬伤伤口中，掌指关节和指间关节屈曲，使得伤口更深地穿透，然后在伤口张开时封闭。葡萄球菌和链球菌是在人咬伤和动物咬伤中最常发现的微生物；狗和猫咬伤应考虑多杀巴斯德菌。
