Bites From Humans Or Mammals

Bites from people or pets (mostly dogs and cats, but also squirrels, gerbils, rabbits, guinea pigs and monkeys) are not uncommon and occasionally lead to serious illness and permanent damage. Affected are usually the hands, limbs and face. For bites of humans and the genitals are occasionally affected.

(Rat-bite fever) bites from humans or pets (mostly dogs and cats, but also squirrels, gerbils, rabbits, guinea pigs and monkeys) are not uncommon and occasionally lead to serious illness and permanent damage. Affected are usually the hands, limbs and face. For bites of humans and the genitals are occasionally affected. Bites from large animals can sometimes have significant tissue trauma results in about 10-20 people, mostly children, die each year by a dog bite. However, most bites usually cause relatively minor wounds. In addition to the infectious tissue trauma cause bites of people due to the bacterial colonization of the human mouth infections. By bites from people theoretically hepatitis and HIV can be transmitted. However, HIV transmission is unlikely, because the concentration of HIV is much lower than in blood in the saliva and make inhibitors in the saliva the virus ineffective. (For risk of rabies (Rabies by animal bites rabies)). Monkey bites that usually occur only with employees of scientific laboratories, carry a certain risk for Herpes B virus viral infections. This infection manifests itself in bubbles on the bite site and can often progress to a fatal encephalitis. Bites on the hand (Infected bites the hand) have a higher risk of infection than bites on other parts of the body. Specific infections are cellulitis (cellulitis) tendonitis (tendinitis and tenosynovitis) Infectious arthritis (Acute infectious arthritis) osteomyelitis (osteomyelitis) This higher risk devotes special attention to a blow on the mouth of the enemy (battle bite). This is the most common human bite wound. In fight bite wound, the skin moves away from the underlying structures destroyed when the hand is opened, whereby the inside bacteria are included. Patients are often reluctant, a treatment whereby the bacteria can multiply unhindered. Human bites at locations other than the hand seem to pose no greater risk of infection than the bite of other mammals. Cat bites to the hand have a high risk of infection, as cats have long, thin teeth, often deep into structures such as joints and tendons, while the small holes close again quickly. Diagnostic test manually bite best in exactly the hand position in which the bite occurred clarification on damage to underlying nerves, tendons, bones and the vascular system and the presence of foreign bodies Human bites happen sometimes in an altercation and then to other causes attributed to prepare the other person or yourself any trouble with the authorities or insurance companies. Domestic violence is often denied. Tips and risks for each wound near the metacarpophalangeal joint, a human bite should be considered, especially if the argument put forward the accident is vague or leaves questions open. Bite marks must be judged first, the extent to which underlying structures (eg. As nerves, blood vessels, tendons and bones) are affected. will also have to search for foreign bodies in the bite wound (wounds review). The assessment of the wound needs to focus on functional limitations and the extent of the wound. Wounds above or in the vicinity of joints during the injured area in the same position is maintained as in the course of the accident (eg. B. clenched fist) should be examined. Wounds are examined under sterile conditions in order to evaluate tendons, bone and joint involvement and to detect foreign bodies. Wounds inflicted by around biting (gnawing) Although often see from less dangerous, but should be investigated even for small abrasions to exclude deep injuries. The microbial investigation of a fresh wound is not effective; a swab of a wound can be done only if there is clear signs of infection are present. A study on hepatitis C or HIV is only indicated if it is known or suspected that the perpetrator is seropositive. Careful treatment wound care wound closure Selective Selective use of prophylactic antibiotics Hospitalization is indicated if complications require very close monitoring, especially in patients in which it is foreseeable that they will take it not as accurate with the aftercare. Hospitalization should be considered in the following cases: When a human bite is infected (including violations of the clenched fist) If a non-human bite is easy or difficult infected if a loss of function is obvious, if the wound is at risk deeper structures or damaged If a wound has lead to a disability or is difficult to maintain at home for. B. considerable wounds both hands or both feet or hand wounds that make a continuous increase necessary The most important treatment measures are as wound cleansing, debridement and infection prevention. Wound care The wound should first with an antibacterial soap and water (tap water is acceptable) to be cleaned. This is followed by rinsing under pressure with plenty of saline. To this end, a syringe or a catheter can be used otherwise for i.v. finds infusions application. For pain appropriate local anesthetics should be applied. Dead and devitalized tissue should be debrided, with special care applies to those wounds that affect the face or hands. Wound closure is indicated only for certain wounds, eg. As those that are minimal and can be effectively cleaned. Most wounds are left open at first, including these: stab wounds injuries to hands, feet, perineum or genitals wounds that are more than a few hours old wounds that are heavily contaminated wounds edematous wounds that show signs of inflammation wounds, the deeper structures (eg. as tendons, cartilage, bone) relate wounds by human bites wounds in a contaminated environment (eg. as in a Miltäreinsatz, in the sewers) is rather a secondary wound closure make also in patients with immunodeficiency , Other wounds such. B. fresh skin cracks, can normally be closed primarily after appropriate wound cleaning. The treatment results in secondary closure is similar to the primary wound closure, so there are no reasons against premature wound closure normally. Bites into the hand should be bandaged with gauze, a hand fixed on a rail (position on the track: the wrist in slight extension, the metacarpophalangeal joint and interphalangeal joints in both flexion). If wounds moderate or severe, the hand should be kept continuously increased, for. As a stick hanging. Bites on the face often require reconstructive surgery so that no cosmetic problems and ugly scars. A primary closure of dog bites in the face of children showed good results, but a prior consultation with a plastic surgeon is recommended. Infected wounds may require debridement, suture removal, Wundbad, the introduction of a rail with raising the limb and the intravenous use of antibiotics depending on the severity and the clinical picture. Should it come to the joint infection and osteomyelitis, it requires a long-term intravenous antibiotic therapy and orthopedic medicine Mitbetreuung.Antimikrobielle A thorough wound cleaning is the best way to prevent infection and is often sufficient. There is no consensus on the administration of prophylactic antibiotics. Such studies could find no discernible benefits and the widespread use of prophylactic antibiotics also carries the risk of the formation of resistant organisms. Drugs do not prevent infection in heavily polluted or insufficiently cleaned wounds. However, many doctors prescribe prophylactic antibiotics for bites on the hand and another bite (z. B. cat bites, monkey bites). Infections are treated with antimicrobial agents that are selected according to the species (see table: Antimicrobial medications for managing a bite). The result of bacteriological cultures from wounds should, if available, to determine the further therapy. Patients with bleeding wounds of people bite a post-exposure prophylaxis of viral infections (acute viral hepatitis include: prevention) should according to the serostatus of the offender and HIV received (human immunodeficiency virus infection (HIV infection): Post-exposure prophylaxis (PEP)). If the status is unknown, prophylaxis is not indicated. Antimicrobial drugs in bite marks drug dose Comments human and dog bites amoxicillin / clavulanic acid 500 to 875 mg po 2 times a day for outpatient prophylaxis: Dosage for 3 days Treatment: dose over 5-7 days ampicillin / sulbactam 1.5-3.0 g iv every 6 h for inpatients effective against ?-hemolytic streptococci, Staphylococcus aureus and Eikenella corrodens trimethoprim / sulfamethoxazole plus. 160/800 mg i.v. every 12 h for patients who are allergic to Penzillin (In children, the dosage depends on the weight) Clindamycin 150-300 mg i.v. every 6 h doxycycline 100 mg p.o. or iv every 12 h alternative for dog bites for patients with allergy to penicillin, except children <8 years old and pregnant women clindamycin plus. 150-300 mg po or iv every 6 h alternative for dog bites in adults fluoroquinolone A (z. B. Ciprofloxacin) 500 mg p.o. every 12 h (Ciprofloxacin) cat bites * a fluoroquinolone (z. B. Ciprofloxacin) 500 mg p.o. po 2 times daily for 5-7 days for the prophylaxis and treatment in adults is effective against P. multocida † clarithromycin 500 mg 2 times daily for 7-10 days alternative for children clindamycin 150-300 mg po about 7-10 days alternative for children monkey bites ‡ acyclovir 800 mg 4 times daily iv 5 times daily for 14 days Prophylaxis * bites by squirrels, gerbils, rabbits and guinea pigs rarely become infected and, if they do ignite, be treated with the same drugs as in cats bite. † Bartonella henselae, cat scratch disease - is ‡ transmitted through cat bites for the treatment of infected monkey bite antibacterial drugs such as in infected human and dog bites are used. Summary The risk of infection by the hand is higher, especially in bite with a clenched fist. Wounds on the hand should be examined in the position in which the wound was inflicted. Wounds should be examined for damage to nerves, tendons, bones and the vascular system, as well as the presence of foreign bodies. Wounds are closed only are minimal and could be effectively cleaned. The risk of infection can be minimized by thorough mechanical cleaning, debriding, and sometimes antimicrobial prophylaxis.

Health Life Media Team

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