Management of animal bite injuries of the face: Experience with 94 patients

Purpose: Because of the large number of bacteria in the oral cavity, animal bite wounds are generally contaminated, and their treatment is difficult because of the risk of infection, especially in extensive injuries. This report describes the management of a large series of patients and recommends treatment guidelines on the basis of the results. Patients and Methods: Ninety-four animal bite wounds on the face and head were analyzed according to the type of animal, location and extent of the soft tissue wound, duration and type of surgical treatment, occurrence of infections and their pathogen spectrum, as well as the choice of antibiotic therapy. Results: Dogs caused 91% of the bite wounds. Infections developed in 4 of 53 patients who underwent primary wound closure with minor edge excision and prophylactic administration of oral penicillin. Without antibiotic administration, 2 of 15 patients had infections, which were treated on an outpatient basis. Of 26 patients with initially delayed treatment, 18 showed clinical inflammatory symptoms with a wide spectrum of pathogens (Escherichia coli, Streptococcus, Enterococcus, Staphylococcus epidermidis, and Proteus) on presentation. Conclusion: Extensive animal bite wounds on the face, even with soft tissue defects, should be treated according to the criteria of a esthetic reconstructive facial surgery. In view of the low infection rate, routine antibiotic prophylaxis is not justified.