The physician’s first priority is to protect the victim from infection. Proper wound management is required to reduce the risk of developing wound infection, sepsis, osteomyelitis, tenosynovitis, and septic arthritis. The wound is cleaned carefully. After cleaning, it is irrigated with normal saline under pressure using a 19-gauge needle and large syringe. A 20-gauge angiographic catheter often is attached and introduced into puncture wounds to facilitate irrigation. Victims frequently state that this is the most painful part of treatment.
It is important to find out when and if the victim had a tetanus shot. Such a shot may be administered if required or the date of the last shot cannot be determined. The dog may be known to be rabid. If so, the victim is treated preventatively for rabies.
Because dogs can develop a tremendous force when biting, x-ray studies might be necessary to determine underlying bone and joint injury. Fractured bones must be set. Nerve injuries must be repaired.
Dog bites to the neck and face require special considerations. Most occur in children younger than 10 years, and severe brain injury and death are most common in this age group. Most deaths occur from hemorrhage from the great vessels of the neck.
Depending on the type of bite, the wounds may be closed. If the damage is not extensive, the wounds may be closed with tape or sutures. High-risk wounds should not be sutured but should receive antibiotic treatment. Low-risk wounds may be sutured and do not require antibiotic treatment unless infected. High-risk wounds include all human and cat bites; hand and foot wounds; wounds surgically debrided; puncture wounds; wounds involving joints, ligaments, tendons, and bones; bites with treatment delay exceeding 12 hours; and bites in immunocompromised patients. Low-risk wounds include bites involving the extremities, face, and body.
Heavily damaged tissue may have to be debrided — cut away. Sometimes it can be reattached by grafting; other times it is replaced with skin from another area of the victim’s body. More than one type of surgery may be required:
- Plastic/reconstructive surgery
- Orthopedic surgery
If you or someone you care for has been injured in a dog bite attack contact our office anytime at 800-437-2571 for a free, no obligation Consult with an experienced dog bite attorney or use our convenient Free Case Evaluation submission form