Management of animal bite injuries of the face: Experience with 94 patients
Management of animal bite injuries of the face: Experience with 94 patients
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DOI：
10.1016/s0278-2391(98)90009-x
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发表时间：
1998-07-01
影响因子：
1.9
通讯作者：
Wolff, KD
中科院分区：
文献类型：
--
作者：
Wolff, KD
目的：由于口腔中有大量的细菌，动物咬伤的伤口通常会被污染，并且由于感染的风险，其治疗很困难，特别是在广泛的损伤中。本报告描述了一个大系列的病人的管理和建议的治疗方针的基础上的结果Patients and Methods：94动物咬伤伤口的面部和头部进行了分析，根据动物的类型，位置和程度的软组织伤口，持续时间和类型的手术治疗，感染的发生和病原菌谱，以及抗生素治疗的选择。91%的咬伤是狗造成的。在53名接受一期伤口闭合、轻微边缘切除和预防性口服青霉素的患者中，有4名发生感染。在未给予抗生素的情况下，15名患者中有2名发生感染，在门诊接受治疗。最初延迟治疗的26例患者中，18例表现出临床炎症症状与广泛的病原体（大肠杆菌，链球菌，肠球菌，表皮葡萄球菌，变形杆菌）presentation.Conclusion：广泛的动物咬伤的伤口在脸上，即使有软组织缺损，应根据美学重建面部手术的标准进行治疗。鉴于感染率低，常规抗生素预防是不合理的。
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.