The following are the most important diseases or complications that may be contributed to by open wounds: Skin and subcutaneous (L00-L99). If wound healing is impaired, transition to ulcer (ulcer) or chronic wound possible – Impaired wound healing may result from: Pre-damaged skin (in peripheral arterial occlusive disease (pAVK), chronic venous insufficiency (venous weakness), polyneuropathy/diseases … Animal Bite: Secondary Diseases
Classification of bite injuries according to severity levels Severity Clinical picture Grade I Superficial skin lesion Laceration Scratch wound Bite channel Crush wound Grade II Skin wound, extending to fascia/musculature/cartilage. Grade III Wound with tissue necrosis or substance defect. Staging of open dog bite injuries in the facial region. Stage Clinical picture I Superficial injury … Animal Bite: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, body height; further: Inspection (viewing). Skin Surrounding tissue adjacent bone/joints Bite wound, of different species: Dog: laceration-squeeze wound Cat: deep, puncture wounds Horse: contusion wound Snake: two pinhead-sized puncture wounds] Signs of infection: … Animal Bite: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Bacteriology (determination of pathogen and resistance); in synovitis (synovial inflammation) also punctate of the respective joint.
Therapy goals Elimination of the pathogens Avoidance of wound infection Therapy recommendations Antibiotic prophylaxis or therapy should be given for the following indications (duration: 3-5 days; for infected wounds: > 14 days): Primarily open and contaminated wounds. Delayed wound care Bite wounds (animal and human bites; increased risk of infection in cats, about 80%!)Cave: puncture … Animal Bite: Drug Therapy
Obligatory medical device diagnostics Radiographs in two planes – suspected bone or joint injury or penetration or infection of bone or joint.
Note All bite wounds and deep scratch wounds have a high risk of infection (approximately 85%). Inpatient admission is required for all bite injuries of the hand with bone and joint involvement. The consilium hand surgery is recommended in this case. Verification of tetanus protection!If no or insufficient vaccination protection or in case of doubt: … Animal Bite: Surgical Therapy
The following symptoms and complaints may indicate an animal bite: Pathognomonic (evidencing a disease). Bite wound (ragged wound edges, if any; bruised tissue, hematoma/bruising). Dog: laceration-crush wound Cat: deep, puncture wounds Horse: contusion wound Snake: two puncture wounds the size of a needle head Main symptoms Bleeding Pain Secondary symptoms Accompanying injuries to muscles, vessels, … Animal Bite: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Depending on the species, an animal bite results in a laceration-squeeze wound, contusion wound, deep puncture wound, or puncture wound. Germs are deeply implanted in the process. The risk of infection can be as high as 85%. Note: The risk of infection does not depend on the size of the wound … Animal Bite: Causes
General measures Stop bleeding: press firmly on the wound with a clean handkerchief for at least 5 minutes or until bleeding stops. Cleaning the wound with clean water (if necessary a saline solution) or better with a disinfectant. In case of adder bite: keep the bite site as still as possible and transport the patient … Animal Bite: Therapy
Medical history (history of illness) represents an important component in the diagnosis of animal bite. Family history Social history What is your occupation? Current medical history/systemic history (somatic and psychological complaints). Is the bite an animal or human bite* ? Where, in what situation and how were you bitten? Was the bite in a foreign … Animal Bite: Medical History
Injuries, poisonings, and certain other sequelae of external causes (S00-T98) Bite wound, different species Dog: laceration-squeeze wound Cat: deep, puncture wounds Horse: contusion wound Snake: two puncture wounds the size of a needle head
