Definition & Prevalence

Definition

Animal and human bites: Traumatic injuries caused by teeth penetration of skin Types: dog, cat, human bites

General injury types:

• Lacerations
• Abrasions
• Puncture wounds
• Avulsions
• Degloving injuries
• Crushing injuries

Prevalence

Dog (most common) and cat bites are common presentations in the ED. Human bites are the least common.

Different Types

Dog bites:

• Puncture wounds from canine teeth
• Can cause traumatic amputations
• Soft tissue avulsions
• Bone damage
• Devascularisation

Cat bites:

• Small fine puncture wounds
• Less deep than dog bites
• Higher risk of osteomyelitis
• Prone to abscess formation

Human bites:

• Occlusive bite injuries (mostly in women – breast, genitalia, limbs) or clenched fist injuries (mostly in men – usually from fist fights)
• Can be Accidental, Self-inflicted or Deliberate
• <3cm suggests a child bite
• >3cm suggests an adult bite
• If present in children, suspect maltreatment

Investigations

For human bites:

• Assess tetanus risk
• Screen for blood-borne infections:

Hepatitis B: HBsAg testing at time of incident, 6 weeks, 3 months, 6 months later

Hepatitis C: Antibody (at time of incident, 3 months, 6 months later) and PCR testing (6 weeks later)

HIV: Antigen/antibody combo test at time of incident, 6 weeks, 3 months, 6 months later

• Check vaccination status
• Wound assessment for foreign bodies