Animal and Human Bites management

ANIMAL BITES

If rabies is a concern scrub the wound with soap and water for at least 15 minutes then rinse and apply a disinfectant eg: povidone iodine as soon as possible after exposure.

Pre-emptive early antibiotic therapy for 3-5 days is recommended for patients who:

• are immunocompromised

• are asplenic

• have advanced liver disease

• have preexisting or resultant edema of the affected areas

• have injuries that may have penetrated the periosteum or joint capsule.

All Human Bites should receive:

• Prophylactic antibiotics

• Consider postexposure prophylaxis for HIV within 72 hours.

• Hepatitis B vaccine preferably≤ 24 hours if not previously immunized.

Treatment:

DO NOT SUTURE ANIMAL AND HUMANBITES

The wounds should be irrigated copiously, dressed, left open to drain, and examined daily to detect signs of infection.

During the first few days after injury, elevation of the swollen injured body part, especially if swollen, accelerates healing.This should be accomplished using a passive method(a sling for outpatients or a tabulate stockinet and an intravenous pole for inpatients.

All infected wounds should be treated, if no signs of infection, delayed primary closure may be done 72 hours after injury.

Antibiotics:

Amoxiclav 1gm bdx5-7 days

In penicillin allergic patients: clindamycin 300mg po qid/600mg or azithromycin 500mg po OD for 3 days

PLUS

Tetanus Toxoid 0.5mg IM

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