Goals

To achieve hemostasis, reduce the risk of infection, repair tissue integrity, and restore function.

Background

Animal bites refer to any wound to humans from a domestic or wild animal, including humans. Bites may result in a laceration, puncture wound, scratch, or crush injury. The most common site for bites is the extremities and second is the head and neck. The majority of bites are from animals known to the victim, such as a pet or pet of an acquaintance. Dog bites are most likely to result in a crush injury, whereas cat bites are more likely result in puncture wounds. All bite wounds are at risk for infection and the most likely organism is dependent on the animal species responsible for the bite (see chart in Procedure Steps section). Providers should maintain a high level of suspicion for rabies when bites are unprovoked (from the point of view of the animal) or when the offending animal cannot be located or quarantined. Complications of animal bites include sepsis, osteomyelitis, septic arthritis, hemorrhage, meningitis, endocarditis, post-traumatic stress disorder, or death.

Contraindications

The following situations may warrant immediate referral:

• extensive or deep wounds
• confirmed or suspected muscle, tendon, nerve, or vascular compromise
• significant edema or crush injury
• hemorrhage
• open fracture
• amputation of digits
• bites involving the face or genitalia
• signs of sepsis
• fever
• spreading cellulitis
• bite from a potential rabid animal