Bites

Bites represent special risks for laceration repair. Cat bites often involve deep puncture wounds and should be cleaned and irrigated thoroughly and not closed but allowed to heal by secondary intention. Untreated cat bite infection rates are 18% to 33% (Dire, 1991). Treating cat bites with prophylactic antibiotics significantly reduces infection rates. Dog bites may be more lacerated and after high-pressure flushing at greater than 7 psi (obtained using 50-cc syringes and saline or iodine in water in 1:10 ratio) may be closed primarily in the first 6 hours after the injury. Infection rates for dogs are less than 20% (Dire, 1992).

Primary closure by suturing is not generally recommended for nonfacial bite wounds, especially deep punctures, bites to the hand, and clinically infected wounds. Anecdotal data suggest an increased risk of infection after closure of these wounds. Sterile skin closure strips or delayed closure may be appropriate (Singer et al., 2008a).

Human bites on the hands and specifically overlying the metacarpophalangeal joints are problematic because of potential damage to underlying tissue, tendons, and joint

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