Human bite
Cards (8)
- Human bites have a high rate of infection.
- Symptoms:
- Area of the bite will most likely be painful and tender to touch
- Bite results in a semi-circular or oval red patch and may have bruising associated with it
- Complications:
- Higher rate of infection - extensive bacterial flora of the human mouth and skin
- Pathogens in human bite wounds include both aerobic and anaerobic bacteria
- Subcutaneous abscess
- Osteomyelitis
- Septic arthritis and tendonitis, especially if over the knuckle area
- Bacteraemia
- Initial management:
- Wounds that have broken the skin surface should be stabilised
- Stop active bleeding by applying direct pressure
- Assess neurovascular function and extent of damage distal to the wound
- Irrigate the wound with sterile saline solution and remove visible debris
- May require debridement
- Patients with infected bite wounds on initial evaluation need to be sent to hospital for assessment
- Signs of infection:
- Fever
- Erythema
- Swelling/local cellulitis
- Fluctuance
- Necrotic tissue
- Purulent discharge
- Lymphangitis
- Lymphadenopathy
- If facial bite - need to perform an intraoral exam to exclude cheeky lacerations with an intraoral communication
- Wound care:
- Swabs should be taken to aid in antibiotic management - especially if patient is high risk of MRSA (recent hospital, drug users, military)
- Elevate to ease swelling and pain
- Generally left to heal by secondary intention - facial wounds are repaired by plastic surgeons
- Treatment:
- Prophylactic antibiotics are given for 3-5 days
- Co-amoxiclav OR
- Doxycycline and metronidazole
- Assess the person's risk of tetanus and blood borne infection
- Tetanus toxoid offered to those without a recent booster (last 5 years)
- Tetanus immune globulin and tetanus toxoid should be offered to patients with less then 2 primary immunisations