23 year old dude was walking in his neighborhood, listening to the latest Pitbull jam, when a domesticated unleashed dog attacks him. Vitals are normal. Musical taste is questionable. He has a few abrasions and small lacerations on his lower leg, ambulating normally, no other signs of trauma.
What do you do for this patient?2. XR if you are worried about any retained dog teeth or other foreign bodies, or any bony involvement. Look out for crush injuries with dog bites.
3. To suture or not?? General practice is to AVOID primary closure with sutures unless all of the following are met: on the face/scalp, within < 6 hours, with simple lacerations, and in an immuno-competent host.
Do you give antibiotics?
When do you give antibiotics for dog bites? What will you prescribe?
Dog bites can be infected with Pastuerella, staph and strep species, and Capnocytophaga canimorsus. Treat with amoxicillin-clauvulanate for 5-7 days
What about the poor dog?
Worried about rabies if this were a stray dog? See here for management.
What if this were a 48 year-old cat lady bitten on her leg by one of her 13 cats?
By Dr. Kylie Birnbaum
References
Tintinalli’s 7th Ed.
Special thanks to Dr. Willis
Kylie Birnbaum
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