Pediatric dog bite outcomes: infections and scars

Background There is little consensus on the management of dog bite victims. Few studies have examined long-term patient outcomes. This study was designed to evaluate two outcomes: infection and unfavorable scar formation.Methods A retrospective study of dog bite cases from January 2013 to May 2016 w...

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Main Authors: Benjamin Drumright, Breanna Borg, Arlene Rozzelle, Lydia Donoghue, Christina Shanti
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/5/1/e000445.full
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author Benjamin Drumright
Breanna Borg
Arlene Rozzelle
Lydia Donoghue
Christina Shanti
author_facet Benjamin Drumright
Breanna Borg
Arlene Rozzelle
Lydia Donoghue
Christina Shanti
author_sort Benjamin Drumright
collection DOAJ
description Background There is little consensus on the management of dog bite victims. Few studies have examined long-term patient outcomes. This study was designed to evaluate two outcomes: infection and unfavorable scar formation.Methods A retrospective study of dog bite cases from January 2013 to May 2016 was conducted at our level I pediatric trauma center. Forty-five patients were identified who received definitive repair and had long-term follow-up for reasons other than rabies vaccination. Variables recorded were wound characteristics including presence of tissue loss, location in the hospital of the wound repair procedure, personnel performing the repair, postrepair infection, and a binary assessment of unfavorable scar formation.Results Unfavorable scarring was not significantly related to either repair location or personnel. Rate of infection was not significantly related to repair location. However, infection rate was significantly related to personnel performing the repair (p=0.002), with 8 of 11 (73%) infections after repair by emergency physicians compared with surgeons.Discussion The presence of infection was significantly related to bedside repair by emergency physicians. The data are suggestive of differences in wound preparation and repair technique between emergency department and surgical personnel. Standardizing technique could reduce infectious complications and long-term morbidity associated with repairing dog bites and other contaminated wounds. A robust and practical classification system for dog bite wounds would be helpful in stratifying these wounds for research comparison and healthcare triage.Level of evidence The level of evidence for this retrospective study is level III.
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spelling doaj-art-a2b3569b694c422b8f7be85b40c7bba82025-08-20T02:12:33ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762020-12-015110.1136/tsaco-2020-000445Pediatric dog bite outcomes: infections and scarsBenjamin Drumright0Breanna Borg1Arlene Rozzelle2Lydia Donoghue3Christina Shanti4Wayne State University School of Medicine, Detroit, Michigan, USADepartment of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USADepartment of Plastic Surgery, Children`s Hospital of Michigan, Detroit, Michigan, USADepartment of Pediatric Surgery, Children`s Hospital of Michigan, Detroit, Michigan, USADepartment of Pediatric Surgery, Children`s Hospital of Michigan, Detroit, Michigan, USABackground There is little consensus on the management of dog bite victims. Few studies have examined long-term patient outcomes. This study was designed to evaluate two outcomes: infection and unfavorable scar formation.Methods A retrospective study of dog bite cases from January 2013 to May 2016 was conducted at our level I pediatric trauma center. Forty-five patients were identified who received definitive repair and had long-term follow-up for reasons other than rabies vaccination. Variables recorded were wound characteristics including presence of tissue loss, location in the hospital of the wound repair procedure, personnel performing the repair, postrepair infection, and a binary assessment of unfavorable scar formation.Results Unfavorable scarring was not significantly related to either repair location or personnel. Rate of infection was not significantly related to repair location. However, infection rate was significantly related to personnel performing the repair (p=0.002), with 8 of 11 (73%) infections after repair by emergency physicians compared with surgeons.Discussion The presence of infection was significantly related to bedside repair by emergency physicians. The data are suggestive of differences in wound preparation and repair technique between emergency department and surgical personnel. Standardizing technique could reduce infectious complications and long-term morbidity associated with repairing dog bites and other contaminated wounds. A robust and practical classification system for dog bite wounds would be helpful in stratifying these wounds for research comparison and healthcare triage.Level of evidence The level of evidence for this retrospective study is level III.https://tsaco.bmj.com/content/5/1/e000445.full
spellingShingle Benjamin Drumright
Breanna Borg
Arlene Rozzelle
Lydia Donoghue
Christina Shanti
Pediatric dog bite outcomes: infections and scars
Trauma Surgery & Acute Care Open
title Pediatric dog bite outcomes: infections and scars
title_full Pediatric dog bite outcomes: infections and scars
title_fullStr Pediatric dog bite outcomes: infections and scars
title_full_unstemmed Pediatric dog bite outcomes: infections and scars
title_short Pediatric dog bite outcomes: infections and scars
title_sort pediatric dog bite outcomes infections and scars
url https://tsaco.bmj.com/content/5/1/e000445.full
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