HUMAN BITES Flashcards
3rd most common bite wound pattern after dog and cat bites
Human Bites
Typical human oral & and skin flora that cause infection
Eikenella, group A Streptococcus, fusobacterium, staphylococcus, and prevotella
What type of wound is similar to dog/cat bites
Involve teeth closing over and breaking the skin
Occlusive
Bite wound pattern that involves the skin surface striking a tooth resulting in damage to the skin and underlying structures
Clenched-fist “Fight Bite”
What are is typically affected by a clenched fist injury
Dorsal aspect of the 3rd, 4th, or 5th MCP
Where is mouth flora trapped when they are introduced to the open wound
Trapped under the extensor tendon and/or joint capsule as fist is released from clenched position
what is the primary factor in preventing infection from a clenched fist injury
Wound care
Control bleeding, cleaning with soap and water, providone iodine, or CHX
Are human bites a tetanus prone wound
YES
What should be considered when addressing wound closure of a human bite wound
Human bite wounds should not be closed
Why are facial bite wounds closed
Facial laceration are a cosmetic concern
Considerations for facial laceration wound closures
- No S/Sxs of infection
- < 24 hours old
- MO should be contacted
- Antibiotic prophylaxis
What type of human bites do not require prophylaxis
Trivial human bites that do not break the skin or are very superficial
Patients with clinically uninfected wounds + infection risk factors may warrant prophylactic antibiotics for what reasons?
- Lacerations undergoing partial closure and wounds requiring surgical repair
- Wounds on the hand, face, or genital area
What antibiotic prophylaxis is considered when the wound is not yet infected
Amoxicillin clavulanate 8765/125 mg bid x 5 days
Augmentin
Physical exam findings of a clenched fist injury
- Flexed / Extended
- Wound over dorsal aspect of MCP joints (3rd, 4th, or 5th)
- Erythema, warmth, and/or edema overlying wound & joint
- May have purulent discharge
