dog bite

Dog Bite: Short Overview

• What to do with a dog bite? Clean, disinfect and seal the wound (for example with a plaster). On a heavily bleeding bite, press a sterile, sterile material (such as a sterile compress) and apply pressure dressing if necessary.
• Dog Bite riskssevere skin and muscle injuries, nerve injuries (sometimes with subsequent sensory disturbances), vascular injuries (sometimes with dangerous blood loss), bone injuries, wound infection, formation of unsightly scars
• When to the doctor? In principle, every bite wound should be examined by a doctor and, if necessary, treated (especially with heavy bleeding).

Attention!

• Even small bites can catch fire. In the worst case, a life-threatening tetanus or rabies infection develops!
• In case of a severely bleeding dog bite wound you should consult a doctor as soon as possible after the initial care or call the ambulance!
• If the dog has only slightly scratched the skin (abrasion) and you do not want the same with the doctor, you should thoroughly cleanse the wound and observe in the following hours and days. For signs of inflammation (redness, swelling, overheating, increasing pain) immediately to the doctor!

Dog Bite: What to do?

If you irritate or frighten a dog (unintentionally), he can snap fast. Sometimes only the skin is scratched superficially. With his rounded teeth and strong jaw musculature, a dog can also inflict serious tissue injuries on the victim.

Basically, at a Bite wound easier way the following first aid measures are recommended:

• Clean the wound: Clean the bite gently but thoroughly with lukewarm water and soap as soon as it no longer bleeds heavily.
• Disinfect the wound: Use a skin disinfectant to disinfect the dog bite wound.
• Cover woundWhen a small bite wound a patch is sufficient. On the other hand, you should cover a larger bite wound with a sterile dressing or a gauze compress.
• Off to the doctor!

At a Bite wound with heavy bleeding First you have to stop the bleeding: Press a soft, germ-free material (such as a sterile compress) onto the bite or into the wound. Optionally, a pressure bandage is useful. Get the patient immediately to the doctor or alert the emergency services – especially if the bleeding can not stop!

Dog bite: risks

A dog bite carries a number of risks: Firstly, a lot of tissue may have been injured, such as muscles, nerves, blood vessels and bones. On the other hand, invading germs (especially from the dog’s saliva) can trigger a wound infection.

tissue damage

A dog bite can cause tissue damage of varying severity. In mild cases, often only the superficial skin layer (epidermis) is injured.

A dog can also inflict a deeper injury on a person. Often this is a combination of puncture, tear and soreness. Sometimes, the skin then separates from the underlying tissue (such as fatty tissue). Doctors speak of this Ablation (décollement).

In addition, in a deep dog bite next to skin and muscle tissue, nerves, blood vessels and sometimes even bones can be injured. nerve injuries can cause nerve failures (sensory disturbances). This can mean, for example, that in the affected area the sense of touch is no longer as good as before.

at vascular injuries Excess blood can accumulate in a hardly stretchable muscle lodge (= group of muscles surrounded by a fascia). The area swells and hurts hard. Doctors speak here of the so-called compartment syndrome, As a result, muscle weakness and nerve loss may develop.

In infants and young children, a dog bite often has particularly bad consequences: The animal can even easier with them than with older children and adults Bite off or tear off entire body parts (e.g., ears, hands or even the whole head).

Dog bite infection

Whether a bite wound is small or large, superficial or deep – there is always a risk of wound infection. Because in the dog saliva many germs, which get into the wound during the bite and cause an inflammation here. Also bacteria of the skin flora of the bit as well as environmental bacteria can infect the bite wound. But this happens less often than a wound infection by bacteria from the dog saliva.

An infected bite wound is indicated by a swelling and redness that spreads around the wound.

According to research, five to 25 percent of all dog bites lead to a wound infection. In individual cases, the hangs Probability of wound infection in dog bites on various factors. These include:

• Type and degree of soiling of the bite wound
• Extent of tissue destruction
• the individual patient profile, e.g. increased risk of infection in young children, the elderly and weakened immune systems (eg as a result of diabetes, HIV, cancer or cortisone treatment)
• Affected body region (dog bites on the hands, feet, face and genitals often lead to wound infection)

Typical pathogens of dog bite infections are, for example, bacteria of the genera Pasteurella, Streptococcus, Staphylococcus and Neisseria, Also at the risk of a life-threatening tetanus or rabies infection should think of a dog bite.

Some wound infections remain locally limited, But it can also happen that the pathogens spread to other tissues and organs, Possible consequences are then for example:

• cellulitis: This is understood as spreading the inflammation to the surrounding tissue.
• abscess: Pus accumulation in a cavity caused by inflammation-induced melting of tissue
• Gelenkempyem: Pus accumulation in the joint space (by spreading the dog bite infection to an adjacent joint)
• Inflammation of a whole joint (arthritis): This happens in a dog bite infection but rarely.
• sporadically spreading the infection to other organswhich, for example, can lead to osteomyelitis, meningitis or accumulation of pus in the liver, lungs or brain.

It is particularly dangerous if a dog bite infection spreads to the entire body (systemic infection): In this way, a bacterial toxemia (bacterial sepsis) can develop. Affected patients feel very ill and often have a high fever. There is danger to life!

Dog Bite: When to the doctor?

In a dog bite wound is basically a doctor’s visit advisable, Even if the dog with its pointed teeth has left only small wounds in the skin, they can reach very deep, which increases the risk of wound infection. This is because germs from the canine saliva can penetrate deep into the tissue and cause inflammation, while the edges of the wound rapidly adhere to the small entry point in the upper layers of the skin, so that further wound care seems to be unnecessary. Therefore, small bites are generally more dangerous than large bites, which often bleed heavily and close more slowly.

A visit to a doctor is also advisable in a dog bite, because the patient may have a Vaccination against tetanus or rabies needed. These vaccines should be given as soon as possible because both diseases can be life-threatening. For example, the rabies vaccine must be administered within 72 hours of the dog bite if it is to prevent infection safely. So do not hesitate to go to the doctor after a dog bite injury!

Dog bite: Examinations at the doctor

First, the doctor in conversation with the patient or the parents (in children with dog bite) the medical history (anamnesis) raise. Possible questions are:

• Where and when were you (or your child) bitten?
• Has the look of the wound changed since the dog bite? If so, how (swelling, redness, pus, etc.)?
• Stock or is there fever?
• Are there any other complaints such as numbness in the area of ​​the bite wound or movement disorders of the affected body part?
• Are there any pre-existing conditions (such as diabetes)?
• Do you (or your child) take any medications (such as cortisone or other immune suppressants)?

Important for the doctor are also more detailed information about the dog, which has bitten. It is important, for example, which race he belongs to, how his health status and vaccination status look like and whether the animal was conspicuously aggressive, possibly has a lot of saliva and foam in front of his mouth had (rabies suspicion!). If it is not your own dog, you should seek such information from the dog owner and pass it on to the doctor.

Physical examination

After the anamnesis interview a physical examination follows: The doctor will examine the dog bite wound exactly. He looks at how much tissue has been injured, how bad the wound is and whether there are signs of inflammation (such as swelling, redness, overheating, pus). Eventually he will photograph the dog bite wound (for documentation).

In the case of a dog bite on the arm or leg, the doctor also checks the mobility of the affected limb (such as in the elbow or knee joint). Also muscle strength, reflexes and the feeling of the skin (sensitivity) are tested. This can be used to detect possible damage to muscles, tendons or nerves.

blood test

Blood analyzes after a dog bite can show the doctor if patients with a severe bite injury have lost a lot of blood. In addition, certain blood levels indicate a beginning infection. For example, in a dog bite inflammation various inflammatory parameters in the blood are increased, such as the white blood cells (leukocytes) and the C-reactive protein (CRP).

Smear of dog bite wounds

The doctor takes a smear from the bite wound or obtains samples of the wound secretion for a more detailed analysis in the lab. There one checks whether possible pathogens of a dog bite infection can be grown in the sample material. If so, the doctor can then prescribe the patient a suitable drug against the germs.

imaging

If it is suspected that bony tissue has been injured in the dog bite, an x-ray examination can provide clarity. In the case of a dog bite on the face or skull, the doctor usually arranges for computed tomography (CT) or MRI (magnetic resonance imaging, MRI). Both methods provide very detailed images that reveal not only bone injuries, but also soft tissue injuries and bleeding (such as within the skull).

Dog bite: treatment by the doctor

The medical treatment of a dog bite wound depends on which part of the body the animal has bitten and how extensive the injury is. General measures of wound care are:

• Cleaning the bite wound (e.g., with a 1% organoiodine solution)
• wound irrigation with saline
• debridement (Excision of torn, crushed and dead wound tissue)
• Primary wound care: direct wound closure with plaster, tissue adhesive, staples or suture. This is done with uncomplicated bites, which are a few hours old at the most.
• Secondary wound careThe dog bite wound initially remains open (sometimes over days) and is cleaned several times before it is finally closed (e.g., by suture). This is necessary for large and / or gaping wounds as well as infected wounds.
• if necessary, immobilize of injured body part (especially in wound infection)
• if necessary, inpatient treatment (in severe as well as infected bites)

In some cases, the doctor is to the patient to prevent a bacterial wound infection antibiotics give. This can be useful, for example, for fresh deep bites and bites in critical areas of the body (hands, feet, areas near the joints, face, genitals). Even patients with an increased risk of infection (such as diabetics) and those with implants (such as artificial heart valve) often receive preventive antibiotics after a dog bite.

If there is already a bacterial wound infection, it will definitely be treated with antibiotics.

A tetanus vaccination is given by the doctor after a dog bite in the absence of vaccine protection (eg, last tetanus shot too long ago) or unknown vaccination status.

A rabies vaccine is necessary if an infection can not be ruled out (for example, when bitten by a feral dog, bite by a domestic dog, the unusually friendly or aggressive behaves – rabies suspect!).

Prevent dog bite

There are several measures that help to avoid a dog bite:

• Never leave a child alone with a dogeven if it is the otherwise good house dog. Even out of the game, the dog can suddenly feel the child as a threat and bite.
• Watch out for Warning signals of the dog like retreating of the animal, raising of the lips and flashing of the teeth, growls, put on ears, ruffled fur, high-set or trapped tail.
• Do not disturb the dog while eating or sleeping! If you take your food away from a feeding dog or suddenly (and roughly) touches a sleeping dog, it can snap shut.
• Be extra careful when dealing with Mother animals and their puppy.
• separate dogs running to each other Not.
• Avoid loud noise (like screaming) near the dog. The animal can perceive loud noises as a threat and then snap it shut.
• Do not run to or over a strange dog! This can irritate the animal, scare it or awaken its hunting instinct.
• Strange dogs You should only touch or pet if the owner has allowed it (he knows his pet best). Always let the dog bite you before you touch it.

If you have one strange dog without owner You should heed the following rules so as not to risk a dog bite:

• Keep calm and stay still!
• Do not panic and do not scream!
• Do not stare at the dog (especially not directly in the eyes)!
• Say “No!” Or “Go home!” Or something similar with a deep voice.
• At best, stand sideways to the animal – direct confrontation could irritate the animal to a dog bite.
• Wait until the dog loses interest and goes away!

Also clarify your child about the proper handling of dogs! They often endure a dog bite, especially in critical regions such as head and neck.