Dog Bite 101: The Ultimate Guide

  • Clean and evaluate the injury and remove damaged tissue
  • Close severe wounds with stitches or apply a bandage to minor bite injuries
  • Take radiographs if a foreign body or deep tissue injury is suspected
  • Recommend treatment for tetanus or rabies if indicated
  • Refer you to a specialist if there’s extensive damage or a joint is involved
  • Prescribe antibiotics to prevent infection

Rabies vaccines and immunoglobulins: WHO position

PEP consists of the following steps:

  1. All bite wounds and scratches should be attended to as soon as possible after the exposure; thorough
    washing and flushing of the wound for approximately 15 minutes, with soap or detergent and copious
    amounts of water, is required. Where available, an iodine-containing, or similarly viricidal, topical
    preparation should be applied to the wound.
  2. RIG should be administered for severe category III exposures. Wounds that require suturing should be
    sutured loosely and only after RIG infiltration into the wound.
  3. A series of rabies vaccine injections should be administered promptly after an exposure.

 

MBWA! Evidence based Dog Bite Management

  • It appears safe to close all dog bites regardless of location as long as they are < 8 hours old, and copious high-pressure irrigation
  • In patients with non-hand location dog bites, antibiotics are not needed if we leave the wound open for secondary repair.
  • If we primarily close the wound, we should continue to provide antibiotic prophylaxis until someone performs a randomized trial of primary closure +/- antibiotic prophylaxis.

 

Medical Myths in the Management of Dog Bites

  • It appears safe to close all dog bites regardless of location as long as they are < 8 hours old, and copious high-pressure irrigation
  • In patients with non-hand location dog bites, antibiotics are not needed if we leave the wound open for secondary repair.
  • If we primarily close the wound, we should continue to provide antibiotic prophylaxis until someone performs a randomized trial of primary closure +/- antibiotic prophylaxis.