Bites/Lacerations (Bacterial Skin infection)

Question 1

Background

Answer 1

Can be insect, human, or animal

Question 2

Signs and symptoms / Diagnosis

Answer 2

Insect bites snd stings:
Redness, itchiness, or pain and swelling after an insect sting or bite (inc. bites from spiders and ticks) is often caused by a localised inflammatory or allergic reaction rather than an infection, especially when there is a rapid onset.

Human/Animal bites:
If skin break can cause infection. Depends on species that bit, type snd location of wound, patient risk factors for infection.

Question 3

Treatment

Answer 3

Cleaning and debriding the wound, consideration of prophylactic antibiotics, treatment of infectious complications when they develop and appropriate use of vaccinations.

Asses for risk of tetanus, rabies, or a blood-borne viral infection (such as HIV, and hepatitis B, C), and should be managed accordingly.

Systemically unwell REFER.

Prophylaxis
3 days = if below applies
5 day - If wound is clinically infected
Provide if:
- cat or human bite that broke the skin and drew blood OR
- Dog or other pets (exc cats) that broken the skin and drawn blood if it-
Looks contaminated, punctured bones/tendons/vascular, deep or caused significant tissue damage.

Choice of antibiotic:
Has to be signs and symptoms of infection (fever, pains inflammation, discharge, smell)

1st line ORAL - co amoxiclav
ALT Doxycycline + Metronidazole.

1st line IV - Co amoxiclav
ALT cefuroxime OR ceftriaxone, + metronidazole

Question 4

Lacerations, and puncture wounds

Answer 4

Diagnosis:
Detailed history, examine person, asses signs and symptoms,
Look at risk factors etc then you can see if infection risk is high.

Treatment:
Low infection risk -
- clean, close, dress wound. Consider vaccine (tetanus), provide advise.

High risk infection (no refferal) -
- Clean wound
- Dress don’t close wound yet
- Vaccines (tetanus), provide advise
- take Swab b4 starting anitbiotic
Review person 2-5 days
Tetanus vaccine full immunisation = 3 doses + 2 boosters (10yrs apart)
Give immediate tetanus to >10
- Refer to cks on when immediate tetanus should be given for prone/high risk wounds. Mainly depends on when last dose was taken or if up to date with doses.

Aquatic laceration/ punctures (pack):
broad spectrum antibiotics are required, eg, cephalosporin (e.g., ceftazidime) OR
a fluoroquinolone (e.g., ciprofloxacin or levofloxacin).