A Review of Dog Bite Injuries Treated at Pediatric Trauma Center
Aleena Karediya, B.S.; Eric H. Rosenfeld, M.D., M.P.H. ; Daniel Rubalcava, M.D., M.S.H.A.; Edward Buchanan, M.D.; Bindi Naik-Mathuria, M.D., M.P.H.
Baylor College of Medicine/Texas Children's Hospital, Houston, TX
Introduction: Dog bite injuries are a common cause of emergency department visits in the pediatric patient population. We aimed to characterize their spectrum, management, and outcomes at a level 1 pediatric trauma center.
Methods: Retrospective chart review of children treated for dog bite injuries between 2014-2016. Demographics, injury characteristics, treatment and outcomes were analyzed using descriptive statistics and fishers-exact tests.
Results: Amongst 378 patients the median age was 7[IQR:2-9] and 47% were male. The majority (71%) were bitten by familiar dogs. 25(7%) were bitten in multiple anatomical locations. Craniofacial injuries were more common in children <5-years (79% vs. 40%;p<0.01) and extremity injuries were more common in children older than 5 (40% vs. 8%;p<0.01). 193(51%) underwent primary repair, 2(1%) had delayed closure, 3(1%) negative-pressure therapy. 18%(69) patients required admission and IV antibiotics there were 16 severe injuries (Table-1). Median antibiotic days was 10 (IQR 7-10). Wound infection rate was 6% (21/378). Admitted patients who underwent wound repair in the emergency department were more likely to develop wound infection than those repaired in the operating room (38% vs. 5%;p<0.01). There were no deaths.
Conclusion: While most dog bites in pediatric patients are minor, some can cause severe injuries. Young children are more likely to sustain craniofacial injuries, and the majority of bites are from familiar dogs. Outcomes are generally good with appropriate management.
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