Clinical efficacy of primary suturing of dogs bite injuries on the head and face
10.3760/cma.j.cn114453-20191104-00330
- VernacularTitle:头面部犬咬伤暴露伤口一期缝合的临床效果
- Author:
Yongxiang WANG
1
;
Shujuan MA
;
Xiaojiao YAN
;
Fei XIE
Author Information
1. 甘肃省第二人民医院整形外科，兰州 730030
- Keywords:
Head;
Face;
Dogs;
Bites and stings;
Sutures
- From:
Chinese Journal of Plastic Surgery
2020;36(6):645-649
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and clinical efficacy of primary suturing of dog bite injuries on the head and face.Methods:A total of 42 cases with the dog bite injuries of Grade Ⅲ rabies exposure on the head and face(20 females and 22 males, aged from 1 to 81) were enrolled from October 2015 to October 2018 at the Department of Plastic Surgery, The Second People’s Hospital of Gansu Province. The primary suturing was performed after meticulous wound debridement and sufficient irrigation, the patients who were under 11 years old only received rabies vaccine for the rabies post-exposure prophylaxis, whereas the others were reinforced with tetanus antitoxin (1 500 IU) and human rabies immunoglobulin (20 IU/kg) around the wound, followed by Dermatix anti-scarring treatment for at least one year. Post-operative observation included wound healing and potential complications. All patients were followed up for facial deformities and bilateral symmetry, and the scars were assessed using the Vancouver Scar Scale (VSS).Results:Among the 42 cases, 38 cases (90.4%) were Class-A healed, 2 cases (4.8%) were Class-B healed (one of the two cases had a mandibular wound deep in the muscular layer. A deep abscess appeared in the neck 10 days after surgery, and was cured after puncture and drainage), and 2 cases (4.8%) were Class-C healed. Thirty-two patients had fever to different extent 2 to 5 days after surgery, and their body temperatures were below 38.5 ℃. The body temperature returned to normal after 1 to 2 days. During 6-24 months of follow-up, no tetanus and rabies occurred in all cases. During 1 to 2 years of follow-up, 1 of 42 cases had asymmetrical cheek 1 year post-operation. 1 case had scars on the upper eyelid 1 year after operation, and both eyes were asymmetric when eyes were open. Other 40 cases were recovered with bilateral symmetry without dysfunction of opening and closing the mouth and eyes. Facial contour recovery was cosmetically satisfactory with VSS score 1-3.Conclusions:Primary suturing of dog bite injuries on the head and face, according to the rabies prevention and treatment guideline, is a safe and effective treatment. It prevents rabies, and facial deformities and severe scar deformity in patients.
