Our initial therapy in all animal bites includes copious irrigation with saline by means of a syringe with a 19-gauge needle, careful débridement of devitalized tissues, antibiotic prophylaxis with amoxicillin and clavulanic acid, tetanus and rabies prophylaxis, and early repair.
Antimicrobial therapy is indicated for bite wound infections, but the role of antibiotics in the treatment of uninfected animal bite wounds is still a subject of debate. Controversy exists regarding the use of antibiotic prophylaxis in avoiding infections after an animal bite. The indications for antibiotic prophylaxis depend on the time between the bite and its medical treatment, the type of animal, the anatomical structures involved, and the extent of the bite.2 Although wounds on hands with exposed cartilage or delayed therapy are considered at high risk for infection in animal bites and delayed primary closure is recommended, we preferred early repair by immediate primary closure in horse and donkey bites, and no infection developed (Fig. 2).
Our experience shows the safety of primary closure for horse and donkey bite wounds, provided that careful débridement and good cleansing with antibiotic prophylaxis are also performed. An acceptable aesthetic outcome can be achieved only with early primary repair and reconstructive procedures.
Rüştü Köse, M.D.
Özgür Söğüt, M.D.
Cengiz Mordeniz, M.D.
1. Lathrop SL. Animal-caused fatalities in New Mexico, 1993–2004. Wilderness Environ Med
2. Stefanopoulos PK, Tarantzopoulou AD. Facial bite wounds: Management update. Int J Oral Maxillofac Surg
3. Shipkov CD. Nasal amputation due to donkey bite: Immediate and late reconstruction with a forehead flap. Injury Extra
4. Guida G, Nebiolo F, Heffler E, Bergia R, Rolla G. Anaphylaxis after a horse bite. Allergy
5. Vidal S, Barcala L, Tovar JA. Horse bite injury. Eur J Dermatol
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