Human and Animal Bites

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  • Human and animal bites usually lead to infections if not properly managed.

Signs and symptoms

  • Teeth marks or scratches, lacerations
  • Puncture wounds (especially following bites from cats, dogs and monkeys)

Complications

  • Bleeding, lesions of deep structures, wound infection (by mixed flora, anaerobes), tissue necrosis, transmission of diseases (tetanus, rabies, others)

Treatment objectives

  • Prevent and treat infection
  • Minimize soft tissue damage

Non-pharmacological treatment

  • Immediately clean the wound thoroughly with plenty of clean water and soap to remove any dirt or foreign bodies; allow to dry
  • Stop excessive bleeding where necessary by applying pressure
  • Application of ice pack may aid in pain relief and decrease swelling
  • Soak puncture wounds in antiseptic for 15 minutes
  • Thorough cleaning, exploration, and debridement (under local anesthesia if possible)

Pharmacological treatment

Wash wounds with:

Chlorhexidine 0.05% topical solution 

OR

Povidone iodine 10%

 

For pain relief give analgesic

Paracetamol, oral,

 

If wound is infected give   

Amoxicillin, oral,

Adult:

500 mg every 8 hours for 5-7 days

Child: 

15 mg/kg/day in three divided doses for 5-7 days

PLUS

Metronidazole

Adult:

400 mg every 12 hours for 5 days

Child:

10-12.5 mg/kg per dose for 5 days

Tetanus prophylaxis

  • Give 0.5mL of tetanus toxoid for active immunization if not previously immunized within the last 10 years
  • Follow guidelines on the management of rabies if applicable

Referral

  • Refer for specialist care