Treating Dog And Cat Bites To The Hand: Gnawing At Solutions To This Prevalent Problem

Main Category: Dermatology
Also Included In: Veterinary;  Bones / Orthopedics;  Public Health
Article Date: 12 May 2006 - 0:00 PDT


An estimated two million Americans are bitten by a domestic animal each year and 50 percent of Americans will be bitten in their lifetimes, posing a potential major public health issue. According to a study published in the March 2006 issue of The Journal of Hand Surgery, dog and cat bites to the hand can result in serious injury, sometimes requiring hospital admission and surgery. Many of these injuries, however, can be lessened or prevented through early treatment and more careful animal handling.

The old adage, "Don't bite the hand that feeds you," apparently does not apply to man's four-legged friends: In more than 80 percent of domestic bite incidents, the victim knows the animal. Of the nearly 4.7 million dog bites that occur each year -- accounting for approximately 80 percent to 90 percent of domestic animal bites -- about 2 percent of these bites require hospitalization, constituting 1 percent of all U.S. emergency room visits.

The study, which was an extensive review of 111 cases of dog or cat bites to the hand, wrist or forearm, found that injuries ranged from relatively minor wounds to major injuries that included open fractures and persistent deep infections. Approximately two-thirds of patients in the study group required hospital admission at least for intravenous antibiotics, and approximately one-third of animal bite victims in the study required at least one surgical procedure. More than 10 percent of patients required long-term intravenous antibiotics and/or multiple surgeries, incurring medical expenses in excess of $77,000.

However the study also found that many of those cases would have been far less severe if the patient had sought treatment earlier. The average time from injury to evaluation by an orthopaedic hand surgeon was nearly eight days.

"If you have an animal bite to your hand, even from a pet you know, you should seek treatment immediately," stressed lead author of the study, Leon S. Benson, MD, orthopaedic surgeon at the Illinois Bone and Joint Institute in Glenview, Ill., and Fellow of the American Academy of Orthopaedic Surgeons. "Most people don't -- they think it's not that serious or worry there will be consequences for the pet -- so they wait to see a physician and then the injury is more difficult to treat."

Dr. Benson noted that a bite might just need antibiotics on the day it happened, but once an infection has had a few days to set in, the bite could end up requiring far more extensive and costly treatment. Many of the injuries seen in the study could have been prevented if the patient had known to exercise more caution with the animal.

"Most of the animals biting people are not strays or dangerous pets," Dr. Benson said. "They're biting because they're in a position where an animal would naturally bite: They're hurt or frightened, or they're fighting with another animal and the victim tried to separate them."

Because the study's patient population was selected from a small geographic area over a relatively short collection period, the results also suggest that domestic animal bite injuries may represent a major public health issue.

"Early treatment is going to make or break an injury," Dr. Benson emphasized. "If you get bitten, go to the emergency room right away so the bite can be assessed and treated early."

No external funding was provided for Dr. Benson's study. An orthopaedic surgeon is a physician with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system including bones, joints, ligaments, tendons, and nerves.

With more than 29,000 members, the American Academy of Orthopaedic Surgeons (http://www.aaos.org ) or (http://www.orthoinfo.org ) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade ( http://www.usbjd.org ) -- the global initiative in the years 2002-2011 -- to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.

The Journal of Hand Surgery -- the official publication of the American Society for Surgery of the Hand -- publishes 10 issues annually featuring original, peer-reviewed articles related to the diseases and conditions of the upper extremity.

American Academy of Orthopaedic Surgeons
http://www.aaos.org

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