References
How to care for the bite wound patient
Abstract
Bite wounds are commonly encountered in veterinary practice, and their initial management can make the difference between a successful case and one which proves problematic. These wounds can result in a detrimental cascade of physiological responses to the original injury including systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). These wounds require careful assessment, exploration and management and the systemic effects of the injury should also be considered as a priority. Correct and timely management of the bite wound patient can result in a positive outcome but severe cases rely heavily on close and careful assessment and monitoring of the patient as a whole.
Bite wounds are some of the most common traumatic injuries encountered in veterinary practice, with bite wounds in cats and dogs accounting for 10% to 15% of all veterinary traumas in emergency clinics (Kolata et al, 1974; McKierman and Adams, 1984; Seibold, 2004). The degree of severity of bite wounds varies depending on the animals involved, the body condition of the animal, any concurrent medical conditions, e.g. immunocompromised patients, the locations of the wounds, the depth of the wounds, and the amount of underlying tissue damage. The ‘big dog versus little dog’ or ‘dog versus cat’ are common presentations to veterinary practices. The time lapse between injury and presentation, will often dictate the medical and surgical management of the case.
Animals that have suffered multiple bite wounds with deep tissue damage may suffer severe systemic effects. If the animal survives the initial attack, they often present to the hospital in profound shock and require aggressive volume resuscitation, e.g. shock rate fluid boluses of 60–90 ml/kg, before wound management can be thoroughly addressed, in order to correct underlying hypovolaemia and restore perfusion.
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