<< Back to the abstract archive
Acute Treatment of Dog Bite Avulsion Wounds to the Face and Scalp
Suzanne M Inchauste MD, Michele M Gottschlich PhD RD CSP CCRP, Chris Allgeier DTR, Laura E James MS, David A Billmire MD
University of Cincinnati Medical Center
2017-01-31
Presenter: Suzanne M Inchauste
Affidavit:
This material has not been previously published or presented. The concept and design of the project was primarily by Michele Gottschlich and David Billmire, MD. The data collection, interpretation and write up of the abstract were primarily by Suzanne Inchauste, MD. The other members of the project assist with data collection and statistical analysis.
Director Name: David Billmire
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Objective: Acute treatment of dog bite avulsion wounds to the face and scalp can be challenging. This study sought to determine the characteristics of children treated and describe their surgical management.
Methods: A retrospective single institution chart review from January 2003 to July 2016 was performed. Demographics and injury characteristics included patient age, gender, BMI, injury size and location, dog breed. Surgical data assessed of type of procedure(s), complications including infection, hematoma, reoperation, sepsis and death were assessed using Student's t-test and Fisher's exact test.
Results: Seven children (3 female, 4 male) were treated age 1 to 6 years old (mean 3.3 ± 1.6). The total body surface area of the wounds averaged 7.5 ± 2.5% and mean length of stay was 22.7 ± 9.5 days. Six patients (85.7%) underwent first stage surgical debridement. Four patients (57.1%) underwent split thickness skin grafts. Three patients (37.5%) required free flap reconstruction. All free flap patients had cranial bone or significant facial structure loss. There was no skin graft or free flap loss, hematomas, infections, reoperation, readmissions or death. Pit bull dog bites occurred in younger children compared to other dog breeds (2.25 vs. 5 years; p=.0287).
Conclusions: Treatment of avulsion dog bite wounds in the pediatric population can be challenging secondary to the large soft tissue defects. Our center successfully treated these scalp and face wounds with skin grafts or free flap reconstruction. Younger children are at greater risk for more severe injury, all our patients were less than 6 years old.
