May 19, 2021

Take Home Points
  • If youre concerned about a retained foreign body make sure to get imaging
  • There is a higher risk of wound infection associated with age, diabetes, wound size, contamination, and a location not on the head or neck. Other conditions that impair wound healing include renal failure, obesity, malnutrition, immunocompromised status. 
  • Prophylactic antibiotics are not recommended for routine use in wound care.. Antibiotics have a role in select wounds considered high risk for infection.
  • Pain control and administration of an anesthetic may be required before a patient can fully cooperate with examination. 
  • Its ok to get consultation - sometimes the wound is outside of our scope of practice

May 5, 2021

Take Home Points
  • There is no strict golden hour for wound closure. Location, contamination and patient factors all should be taken into account
  • Dog bites can be closed primarily. Bites on the hand and foot are higher risk for infection. If you close, strongly consider adding antibiotic prophylaxis
  • Sterile water is unnecessary for wound decontamination as are additives (ie betadine). Tap water under reasonable pressure (45 psi) is adequate.

July 17, 2014

Animal bites are a common cause of injury in the United States. About 4.5 million Americans/year (5% of all traumatic wounds in the ED) will sustain a bite injury. Dog bites compromise a majority of these wounds. The classic teaching is that dog bites should not be closed primarily and they should all be prophylactically treated with antibiotics. When dog bites become infected, Pasteurella species, specifically P. canis, are the most common pathogens. Amoxicillin-clavulanate (AKA “dog-mentin”) is the antibiotic of choice. It’s also important to keep in mind that Emergency Department repaired lacerations (not just dog bites but all comers) have a 3-7% infection rate. As usual, the dogma (pun intended) is based on minimal if any evidence. Additionally, there are some recent articles that are relevant to the discussion that should be discussed.