Animal Bites Follow-up

  • Author: Suzanne K Doud Galli, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Sep 23, 2011
 

Further Inpatient Care

  • For most animal bites, local wound care with thorough cleansing and perhaps suturing of wound edges may be adequate treatment. Not all authors recommend the routine use of antibiotics following these treatments. However, in the event of more extensive injury or the development of infection, hospitalization may be required.
  • With larger animal bites, bedside debridement may not be adequate. In situations with large amounts of tissue loss or an avulsed appendage, surgical debridement of the wound with immediate reconstruction or salvage of an appendage may be required.
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Further Outpatient Care

  • Patients who are treated and released are advised to return for consultation in the event of local infection or sepsis.
  • Patients treated with suturing require follow-up for removal of sutures and wound care, and some patients may be monitored on an outpatient basis for local wound care.
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Inpatient & Outpatient Medications

  • The routine use of antibiotics for all bite wounds has not been established.
  • Often, persons treated on an outpatient basis are given an oral antibiotic, especially with puncture wounds or wounds that require debridement and suturing.
  • Patients who are admitted and patients who are septic require intravenous antibiotics. Analgesics are prescribed as necessary.
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Transfer

  • If an injury is extensive and has resulted in the loss of a significant amount of tissue or an appendage, the patient may be transferred to a tertiary care referral center. There, a patient can be treated with a vascularized free flap or replantation of the appendage.
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Deterrence/Prevention

  • Exposure to animals is clearly a risk.
  • The best preventative strategy is to avoid aggressive behavior with animals and avoid unfamiliar animals.
  • Teaching young children to avoid unnecessary provocation of animals may lead to fewer incidents of animal bites.
  • Not leaving children unattended in the presence of animals may also prevent attacks.
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Complications

  • Complications can be considered immediate or delayed.
  • Immediate complications include loss of appendage or disfigurement, which may warrant more extensive reconstruction later. Otherwise, infection is the most common complication of animal bites, which may prompt patients who were previously untreated or self-treated to seek treatment for their injuries.
  • Additional complications associated with infection (eg, sepsis, osteomyelitis, septic arthritis) must be avoided or treated appropriately.
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Prognosis

  • Animal bites lead to few fatalities, and most bites are not treated.
  • Even in complicated cases with extensive tissue loss or infection, the prognosis is generally excellent.
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Patient Education

  • Education is the key to prevention. This is pertinent, especially for children, who are at higher risk for a more serious bite injury.
  • Children can be educated at a young age to avoid strange animals and to avoid aggravating familiar animals.
  • The small size of children puts them at risk for aggressive, dominating behavior by animals.
  • For excellent patient education resources, visit eMedicine's Bites and Stings Center and Bacterial and Viral Infections Center. Also, see eMedicine's patient education articles Animal Bites and Rabies.
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Contributor Information and Disclosures
Author

Suzanne K Doud Galli, MD  PhD, FACS, Consulting Staff, Cosmetic Facial Surgery, Private Practice

Suzanne K Doud Galli, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Rhinologic Society, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Philip J Miller, MD, FACS  Assistant Professor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, New York University School of Medicine

Philip J Miller, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American College of Surgeons, American Medical Association, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Clark A Rosen, MD  Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society

Disclosure: Bioform Medical Consulting fee Consulting; Bioform Medical Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS  Vice Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

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