Cranial Maxillofac Trauma Reconstruction 2019; 12(03): 199-204
DOI: 10.1055/s-0038-1660441
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dog Bite Injuries in the Head and Neck Region: A 20-Year Review

Frederik Piccart
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
,
Jakob Titiaan Dormaar
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
,
Ruxandra Coropciuc
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
,
Joseph Schoenaers
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
,
Michel Bila
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
,
Constantinus Politis
1  Department of Oral and Maxillofacial Surgery, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
› Author Affiliations
Funding None.
Further Information

Publication History

30 November 2017

20 April 2018

Publication Date:
22 June 2018 (online)

Abstract

Dog bite–related wounds seem to have become a common problem, especially when they relate to the head and neck region. According to Overall and Love, up to 18 per 1,000 people sustain a dog bite every year, of whom 3 need medical attention. Approximately 1 to 2% of bite injuries require hospitalization of the victims. Most of the lacerations are found in the upper lip and the nose regions and they are classified according to severity and concomitant damage to other organs. Bite wounds are considered “dirty” wounds and are prone to infection. When dealing with bite wounds, there is always an indication for antibiotic treatment. Broad-spectrum antibiotics like amoxicillin-clavulanate and/or moxifloxacin cover most of the pathogenic flora and should be administered in every bite wound case at risk of infection. This article would like to present a medical record review: a retrospective analysis of all bite wounds sustained in the head and neck region, treated at the University Hospital of Leuven over the past 20 years. Furthermore, it provides an overview of the current literature and its standings on the treatment of dog bite injuries in the maxillofacial region. We assessed both surgical and medical treatment options, as well as primary management, which includes infection prevention strategies, closure management, and additional vaccination requirements. Secondary management or scar revision methods will be mentioned. After conducting a UZ Leuven database search using keywords such as “dog,” “dog bite,” “face,” “head,” “lip,” and others, 223 patients were included. Age at the time of injury, location of the injury, treatment method used, and whether secondary infection was present or not were documented. All patients have been divided in age groups. We concluded that 21.52% was 5 years old or younger. Almost half of our patients (49.33%) were 18 years old or younger. Of all patients, 79 were hospitalized (35.43%). Primary closure was the treatment of choice. In 141 patients, the wounds were closed primarily (63.23%), resulting in only 2.24% reported secondary infections. Only one fatality was reported in our center over the course of 20 years (0.45%), a 6-year-old girl who had been attacked by her father's Rottweilers. Most patients who sustained dog bite injuries in the head and neck region seem to be children, specifically toddlers. Due to their height, it is possible they are more prone to dog bite injuries in the head and neck region. It is essential to optimize management of these injuries due to the impact they have on patients. This article provides the epidemiological data and clinical outcome of the approach at our center.

Informed Consent

No patients were involved in setting the research question or the outcome measures, nor were they involved in developing plans for design or implementation of the study. All clinical images of patients were anonymized.


Compliance with Ethical Statements

The protocol was approved by the Ethics Committee of our institution (University Hospitals of Leuven; file number S60452) and was conducted according to the principles expressed in the Declaration of Helsinki.[21]