Animal Bite Injuries in Children: Review of Literature and Case Series
Aviral Agrawal, Ruchi Singhal, Virendra Singh
Animal bite injuries, Dog bites, Facial trauma
Citation Information :
Agrawal A, Singhal R, Singh V. Animal Bite Injuries in Children: Review of Literature and Case Series. Int J Clin Pediatr Dent 2017; 10 (1):67-72.
CC BY-NC 4.0
Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.
Introduction: Maxillofacial region in children is particularly vulnerable to animal bite injuries. These injuries may range from insignificant scratches to life-threatening neck and facial injuries. Children are the common victims, particularly of dog bites.
Materials and methods: Three cases of animal bite injuries in children with their clinical presentation and their management are being presented along with review of literature. Surgical management included cleansing and primary closure of the wound. Rabies and tetanus prophylaxis were given.
Discussion: The most common site of injury was the face. For the facial injuries, the most frequently affected area was the middle third (55%), also called as the “central target area.” The small stature of children, the disproportionate size of the head relative to the body, their willingness to bring their faces close to the animal, and limited motor skills to provide defense are believed to account for this. The resulting soft-tissue injuries can vary in relation to their extent. Treatment involved initial surgical exploration, and secondary repair later depending on the severity of the injury.
Conclusion: Prompt assessment and treatment can prevent most bite wound complications. Early management of such injuries usually guarantees satisfactory outcome. Prevention strategies include close supervision of child-dog interactions, better reporting of bites, etc.
Schalamon J, Ainoedhofer H, Singer G, Petnehazy T, Mayr J, Kiss K, Höllwarth ME. Analysis of dog bites in children who are younger than 17 years. Pediatrics 2006 Mar;117(3):e374-e379.
De Keuster T, Lamoureux J, Kahn A. Epidemiology of dog bites: a Belgian experience of canine behaviour and public health concerns. Vet J 2006 Nov;172(3):482-487.
Karlson TA. The incidence of facial injuries from dog bites. JAMA 1984 Jun;251(24):3265-3267.
Shaikh ZS, Worrall SF. Epidemiology of facial trauma in a sample of patients aged 1-18 years. Injury 2002 Oct;33(8):669-671.
Goldstein EJ. Bite wounds and infection. Clin Infect Dis 1992 Mar;14(3):633-638.
Walker T, Modayil P, Cascarini L, Collyer JC. Dog bite fracture of the mandible in a 9 month old infant: a case report. Cases J 2009 Jan;2(1):44.
Sacks JJ, Kresnow M, Houston B. Dog bites: how big a problem? Inj Prev 1996 Mar;2(1):52-54.
Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA 1998 Jan;279(1):51-53.
Lackmann G, Draf W, Isselstein G, Tollner U. Surgical treatment of facial dog bites injuries in children. J Craniomaxillofac Surg 1992 Feb-Mar;20(2):81-86.
Méndez Gallart R, Gómez Tellado M, Somoza Argibay I, Liras Muñoz J, Pais Piñeiro E, Vela Nieto D. Mordeduras de perro. Analisis de 654 casos 10 anos. An Esp Pediatr 2002 May;56(5):425-429.
Tuggle DW, Taylor DV, Stevens RJ. Dog bites in children. J Pediatr Surg 1993 Jul;28(7):912-914.
Wiseman NE, Chochinov H, Fraser V. Major dog attack injuries in children. J Pediatr Surg 1983 Oct;18(5):533-536.
Akhtar N, Smith MJ, McKirdy S, Page RE. Surgical delay in the management of dog bite injuries in children, does it increase the risk of infection? J Plast Reconstr Aesthet Surg 2006;59(1):80-85.
Dire DJ. Cat bite wounds: risk factors for infection. Ann Emerg Med 1991 Sep;20(9):973-979.
Kesting MR, Hölzle F, Pox C, Thurmüller P, Wolff KD. Animal bite injuries to the head: 132 cases. Br J Oral Maxillofac Surg 2006 Jun;44(3):235-239.
Palmer J, Rees M. Dog bites of the face: a 15 year review. Br J Plast Surg 1983 Jul;36(3):315-318.
Overall KL, Love M. Dog bites to human-demography, epidemiology, injury and risk. J Am Vet Med Assoc 2001 Jun;218(12):1923-1934.
Scheithauer MO, Rettinger G. Bite injuries in the head and neck area. HNO 1997 Nov;45(11):891-897.
Abuabara A. A review of facial injuries due to dog bites. Med Oral Patol Oral Cir Bucal 2006 Jul;11(4):E348-E350.
Tu AH, Girotto JA, Singh N, Dufresne CR, Robertson BC, Seyfer AE, Manson PN, Iliff N. Facial fractures from dog bite injuries. Plast Reconstr Surg 2002 Apr;109(4):1259-1265.
Brogan TV, Bratton SL, Dowd MD, Hegenbarth MA. Severe dog bites in children. Pediatrics 1995 Nov;96(5 Pt 1): 947-950.
Rosenthal DU. When K-9s cause chaos: an examination of police dog polices and their liabilities. NYL Sch J Hum Rts 1993;11;279-310.
Presutti RJ. Prevention and treatment of dog bites. Am Fam Physician 2001 Apr;63(8):1567-1572.
Jones, RC; Shires, GT. Bites and stings of animals and insects. Principles of surgery. New York: McGraw-Hill; 1979. p. 232-242.
Pinsolle J, Phan E, Coustal B. Les morsures de chien au niveau de la face. Ann Chir Plast Esthet 1993 Aug;38(4):452-456.
Wolff KD. Management of animal bite injuries of the face: experience with 94 patients. J Oral Maxillofac Surg 1998 Jul;56(7):838-843.
Javaid M, Feldberg L, Gipson M. Primary repair of dog bites to the face: 40 cases. J R Soc Med 1998 Aug;91(8):414-416.
Kountakis SE, Chamblee SA, Maillard AA, Stiernberg CM. Animal bites to the head and neck. Ear Nose Throat J 1998 Mar;77(3):216-220.
Mitchell RB, Nanez G, Wagner JD, Kelly J. Dog bites of the scalp, face, and neck in children. Laryngoscope 2003 Mar;113(3):492-495.
Callham ML. Treatment of common dog bites: infection risk factors. JACEP 1978 Mar;7(3):83-87.
Gonnering RS. Orbital and periorbital dog bites. Adv Ophthalmic Plast Reconstr Surg 1987;7:71-80.
Goldstein EJ, Citron DM, Finegold SM. Dog bite wounds and infection: a prospective clinical study. Ann Emerg Med 1980 Oct;9(10):508-512.
Mcheik JN, Vergnes P, Bondonny JM. Treatment of facial dog bite injuries in children: a retrospective study. J Pediatr Surg 2000 Apr;35:580-583.
Stefanopoulos PK, Tarantzopoulou AD. Facial bite wounds: management update. Int J Oral Maxillofac Surg 2005 Jul;34(5):464-472.
Rhee ST, Colville C, Buchman SR. Conservative management of large avulsions of the lip and local landmarks. Pediatr Emerg Care 2004 Jan;20(1):40-42.
Metzger R, Kanz KG, Lackner CK, Mutschler W. After cat bite antibiotics are obligatory. Acute management of bite injuries. MMW Fortschr Med 2002 May;144(18):46-49.
Baker MD, Moore SE. Human bites in children: a six-year experience. Am J Dis Child 1987 Dec;141(12):1285-1290.
Strady A, Rouger C, Vernet V, Combremont AG, Remy G, Deville J, Chippaux C. Animal bites. Epidemiology and infection risks. Presse Med 1988 Nov;17(42):2229-2233.
Goldstein EJ. Current concepts on animal bites: bacteriology and therapy. Curr Clin Top Infect Dis 1999;19:99-111.
Correira K. Managing dog, cat, and human bite wounds. JAAPA 2003 Apr;16(4):28-37.
Dire DJ, Hogan DE, Walker JS. Prophylactic oral antibiotics for low risk dog bite wounds. Pediatr Emerg Care 1992 Aug;8(4):194-99.