Diversity of Spectrum and Management of Animal-Inflicted Injuries in the Pediatric Age Group: A Prospective Study from a Pediatric Surgery Department Catering Primarily to the Rural Population

Abstract

Introduction: Animal-inflicted injuries continue to be a major health problem worldwide. In developing countries, the outcome of such injuries, especially in children may be poor.

Aim: The study aimed to evaluate the diversity of spectrum and management of animal-inflicted injuries in the pediatric age group.

Materials and methods: This was a prospective study on animal-inflicted injuries in children between 1 to 15 years of age over a period of 12 months. Data on various parameters such as age and sex, animal species involved, provoked/unprovoked, mechanism of injury, time of injury, prehospital care, injury-arrival interval, pattern and type of injury, trauma score, body region injured, treatment given and complications were collected and analyzed.

Results: Fifty-two children with animal-inflicted injuries were included, constituting <1% of all trauma cases seen during the study period (male:female = 2:1). The mean age of the cohort was 9.65 years. Domestic animals were responsible in 41 children (78.84%) and wild animals in 11 children (21.16%). Dog bite was the most common (57.69%). Penetrating injury was observed in 40 (76.9%) and blunt injury was observed in 12 (23.1%). The musculoskeletal system was the most common organ-system injured affecting 36 children (69.23%). Thirty-five children (67.3%) after minor treatment were discharged. Seventeen children (32.7%) required admission. Thirty-four children (65.38%) underwent surgical procedures. Wound debridement was the most common procedure performed. Wound infection was observed in 20 children (38.46%) and was significantly higher (P < 0.01) in delayed presenters. The length of hospital stay for the admitted children ranged from 3 to 28 days.

Conclusion: Animal-inflicted injuries are rare in children and have a wide spectrum of presentation. Severe injuries require extensive resuscitation and expert surgical care. Mild injuries can be managed conservatively with the use of proper dressings, antibiotics, and analgesics.

Keywords: Animal-inflicted injuries; children; dog bite; domestic animals; injury patterns; rural; wild animals.

Figure 1

Gore injury inflicted by the pig. (a) Eviscerated bowel loops, (b) Perforated gastric wall, (c) Diaphragmatic rent

Figure 2

Dog bite. (a) Puncture wounds, (b) Free air under diaphragm, (c) Gastric perforation