Mammalian bite injuries to the head and neck region

Abstract

Objective: To determine the frequency and presentation of mammalian bite injuries to the head and neck region seen in a plastic surgery unit.

Design: Observational study. PATIENTS AND DURATION OF STUDY: The Plastic and Reconstructive Surgery Unit, PGMI, HMC, Peshawar from July 1999 to June 2003.

Patients and methods: During the study period 40 patients presented with mammalian bite injuries to the head and neck region. Information about patient's demographics, biting animal, circumstances of sustaining injury, duration of injury, location and extent of injury, treatment administered, cosmetic outcome and complications were noted.

Results: The mammalian bite injuries accounted for 10% of patients managed within the study period for soft tissue injuries to the orofacial region. Among the 40 cases studied, 3 patients were females and 37 were males. Age ranged from 2.5 years to 71 years with the mean of 23 years. The duration of injury varied from 1 hour to 1 year (median 3+2 days). Mammals implicated were humans, dogs, horse, donkey, bear and wolf. All of the 40 patients presented with head and neck injury. Auricular injury was seen in 10 patients, lip injuries in 10 patients, nasal injuries in 10 patients, cheek injuries in 6 patients and scalp injuries in 4 patients. In 70% (28) of cases avulsion of tissue (type-III) was noted. Patients presenting earlier for treatment achieved better cosmesis than the patients presenting late in the course of their injury.

Conclusion: Mammalian bite injuries to the head and neck region can result in facial disfigurement with distressing physical and psychological consequences. Early management of such complex injuries usually guarantees satisfactory outcome.