A small hole-shaped wound, v. a. in bite human or cat can cause significant damage to tendons, joint capsules or articular cartilage. The most common cause of human bite wound is the injury of a MCP joint through the teeth at a blow on the mouth (damage to the fist). The human mouth flora includes Eike Ella corrodens, staphylococcus, streptococcus and anaerobes. Patients with this type of trauma often wait hours or even days before they can treat the wound, which exacerbated the severity. Animal bites often contain multiple, potentially pathogenic bacteria, so Pasteurella multocida (v. A. In cats bites), staphylococci, streptococci and anaerobes. Among the possible serious complications include infectious arthritis and osteomyelitis. Diagnosis Clinical evaluation Radiographs should be suspect an infection If redness and pain at the bite wound. Pressure pain in the tendon course speak for propagation in the tendon sheath. Significant pain amplification in movement speaks for an infection of the joint or tendon sheath. The diagnosis is made clinically when the skin is however broken, radiographs should be made to detect a fracture, tooth fragments or other debris that could pose a stove continuous infection. Therapy debridement antibiotics for the treatment include surgical wound debridement with held open wound, and antibiotics. In outpatient care, the immediate empirical antibiotic use either monotherapy with amoxicillin / clavulanic acid contains 500 mg po 3 times daily, or a combination therapy with penicillin 500 mg po 4 times a day (for E. corrodens, P. Multocida, Streptococcus and anaerobes) plus a cephalosporin (z. B. cephalexin 500 mg po 4 times a day) or a semi-synthetic penicillin (z. B. dicloxacillin 500 mg po 4- times daily) for staphylococci. In regions where MRSA is prevalent, trimethoprim / sulfamethoxazole, clindamycin, doxycycline or linezolid should be used instead of a cephalosporin. At a penicillin allergy can Clindamycin 300 mg p.o. every 6 h are used. The hand should be stored splinted in the functional position and is raised (see Fig. Rail in the functional position (20 ° extension of the wrist 60 ° flexion of the metacarpophalangeal joint, slight flexion of the interphalangeal joint).). Rail in the functional position (20 ° extension of the wrist 60 ° flexion of the metacarpophalangeal joint, slight flexion of the interphalangeal joint). Not Infected bites should be surgically cleaned and treated prophylactically with the same antibiotics, such as those used for infected wounds in half dosage.