Clinical features and management of animal bites in an emergency department: a single-center experience

ABSTRACT

Objectives

This study aimed to evaluate the clinical features, management, and outcomes of patients with animal bites presented to the pediatric emergency department of a tertiary center.

Methods

Patients with ICD-10 code W54 (contact with dog) and W55 (contact with other mammals) between March 1^st, 2017, and July 1^st, 2021, were included in the study. Demographic characteristics of the patients, type of contacted animal, wound characteristics (muscle involvement, soft tissue defect, vascular injury, type of nerve injury, and Lackmann’s classification), wound care measurements, tetanus prophylaxis, administration of rabies immunoglobulin and antibiotics, location of the injury, existing fractures, suturing, splinting, surgical consultations and hospitalization status were recorded.

Results

Four hundred and nineteen incidents of animal bites (240 males and 179 females) occurred over a four-year period. 51% was due to a dog bite; 47% was by a cat. The median age was nine years (IQR: 5–14 years). Most bites (91.6%) involved only a single anatomical site. The extremities were the commonly involved part (right upper limb [35.3%], left upper limb [21.2%], right lower limb [12.6%], left lower limb [16%]). Head-neck and face injury ratio was 17.6%. Torso (5.7%) and genitalia (5.2%) were uncommonly involved. A consultation was requested from at least one surgical department for 8% of the patients. 97.1% of patients received a rabies vaccine. Most attacks were trivial and did not require hospitalization.

Conclusion

Animal bites often cause minor injuries. However, multiple dog attacks can be seen related to a high number of stray animals in our country. Therefore, these patients may present with major traumas. Surgical intervention and hospitalization may be required. Emergency physicians play an essential role in acute management and rabies prophylaxis in these patients.

KEYWORDS:

• Animal bites
• cat
• dog
• emergency department
• horse
• rabies

Disclosure of any financial/other conflicts of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics approval and consent to participate

The written consent from families of the patients was obtained according to the Declaration of Helsinki (1964), and the ethics committee approved the study (GO 21/1379).

Authors’ contributions

Manuscript OA, OT; literature search OA, OT; figure OA, OT; study design OA, OT; data collection OA, ETAG, ZAA, MS; data analysis OA, OT; data interpretation OA, OT; writing OA, OT. All authors read and approved the final manuscript.

Additional information

Funding

No funding was received for the production of this manuscript.