Is the management of dog bite wounds evidence based? A postal survey and review of the literature

Eur J Emerg Med. 2004 Dec;11(6):313-7. doi: 10.1097/00063110-200412000-00003.

Abstract

Objectives: To determine current practice in the management of dog bite wounds with regard to the use of prophylactic antibiotics and primary closure and to compare the available evidence.

Methods: We conducted a national postal survey of Accident and Emergency (A and E) departments in the UK to ascertain the current practice in the management of recent dog bite wounds. A questionnaire was designed and posted to a named A and E consultant. Non-respondents were sent a single reminder 8 weeks after the initial mailing. A detailed literature search was carried out using Medline, Embase and Cochrane databases to look at the available evidence.

Results: The postal survey yielded an 80% response. Prophylactic antibiotics were routinely used by 53% of the respondents. Although 99% of the respondents were happy to close facial dog bite lacerations, 60% were reluctant to suture other body regions. Recent available evidence suggests that restricting the use of prophylactic antibiotics for high-risk dog bite wounds and the primary suturing of appropriate dog bite lacerations is safe.

Conclusions: The management of recent dog bite wounds is not entirely evidence based in many A and E departments in the UK.

Publication types

  • Review

MeSH terms

  • Animals
  • Bites and Stings* / complications
  • Bites and Stings* / therapy
  • Delivery of Health Care / methods
  • Delivery of Health Care / standards
  • Dogs*
  • Health Care Surveys
  • Humans
  • Surveys and Questionnaires
  • United Kingdom
  • Wounds and Injuries* / etiology
  • Wounds and Injuries* / therapy