Human Bites Follow-up

  • Author: Ian K McLeod, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Dec 2, 2011
 

Further Inpatient Care

  • Some patients require hospitalization for the administration of intravenous antibiotics and observation or for surgical intervention. Inpatient observation facilitates prompt surgical intervention if no improvement is noted or the clinical situation deteriorates.
  • Indications for hospitalization are as follows:
    • Injuries of severity requiring surgical exploration or complex wound closure; clinical situation dictates length of stay
    • Systemic manifestations of infection (eg, fever, chills, elevated WBC count)
    • Substantial comorbidity
    • Failure to improve with initial outpatient management
    • High likelihood of noncompliance (eg, emotionally disturbed, mentally handicapped, chronic alcoholism, homeless)
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Further Outpatient Care

  • Patients evaluated early and without evidence of infection may be treated as outpatients without antibiotics.
  • Follow-up should be done within 48-72 hours for reassessment.
  • Development of any signs or symptoms of infection indicate the need to seek immediate medical attention.
  • Patients with mild-to-moderate infections who are likely to be compliant may be treated as outpatients with oral antibiotics. Instruct these patients to return for follow-up within 24-48 hours and to seek medical attention immediately if their clinical condition deteriorates.
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Complications

  • Complications may result from scarring or infection and include the following:
    • Cosmetic deformity resulting from wound contraction
    • Osteomyelitis
    • Abscess formation
    • Transmission of disease (eg, hepatitis B or C, HIV)
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Patient Education

  • Patients should be informed about and fully understand the following:
    • Signs and symptoms of wound infection that require immediate reevaluation (eg, fever, odor, drainage, purulence, swelling, cellulitis, warmth, pain, decreased range of motion, any other abnormal sign or symptom)
    • Importance of early and regular follow-up for this seemingly minor injury and the potential complications that may develop, even with complete compliance with the care plan
    • Rationale for providing antibiotics and the importance of compliance
  • Inform patients that wound revision for cosmetic or functional purposes may be indicated at a later date.
  • For excellent patient education resources, visit eMedicine's Bites and Stings Center. Also, see eMedicine's patient education article Human Bites.
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Contributor Information and Disclosures
Author

Ian K McLeod, MD  Assistant Professor, Department of Surgery, Uniformed Services University of the Health Sciences; Chief, Otolaryngology Service, DeWitt Army Community Hospital

Ian K McLeod, 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.

Coauthor(s)

Daniel J Gallagher III, MD  Attending Surgeon, Department of Otolaryngology, Walter Reed and DeWitt Army Hospitals

Daniel J Gallagher III, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Medical Association

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

David W Stepnick, MD  Associate Professor, Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland Case Medical Center

David W Stepnick, 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, American Society for Head and Neck Surgery, and Society of University Otolaryngologists-Head and Neck Surgeons

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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