Cat bites of the hand

ANZ Journal of Surgery - Tập 74 Số 10 - Trang 859-862 - 2004
Sergei Mitnovetski1, Frank W. Kimble1
1Department of Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Tasmania, Australia

Tóm tắt

Background: Cat bites are the second most common mammalian bites. Cat bites of the hand in particular represent a potentially devastating problem in terms of wound infection and long‐term disability if not treated appropriately. The purpose of the present study is to give an overview of demographics, management and follow up of the patients with cat bite injuries of the hand treated at the Royal Hobart Hospital.

Methods:  Retrospective and prospective data of all patients with cat bites of the hand seen at the Royal Hobart Hospital for a period of 3 years (January 2000 to April 2003) were collected. Demographics, anatomical site, presentation, assessment, investigations, management and follow up of the patients with this type of injury were analysed. The accuracy of the obtained data was checked by analysing questionnaires returned by our patients.

Results:  Forty‐one patients were treated for cat bites of the hand. Twenty‐six were managed in the department of emergency medicine and 15 were admitted and managed by the department of plastic and reconstructive surgery. Five of 15 admitted patients required surgery. Compliance was not a major problem in our study as very few patients were lost to follow up. Almost all patients had close follow up and extensive hand physiotherapy achieving overall good long‐term results. Out of 39 patients who were sent questionnaires only one indicated long‐term problems with the hand (response rate 46%).

Conclusion: Appropriate early treatment of cat bites of the hand is the key to success. Treatment with antibiotics, surgical drainage, debridement and copious irrigation, and use of corticosteroids in some cases, proved to be effective. Hand elevation and intensive physiotherapy after a short period of immobilization is critical. We believe that prophylactic antibiotics should be given even in case of a minor infection following cat bites of the hand. Clear guidelines for clinical recognition of infection, hospital admission and management are provided in our study.

Từ khóa


Tài liệu tham khảo

10.1093/clinids/14.3.633

10.1016/S0196-0644(80)80153-3

Rest J, 1985, Management of human and animal bites, Emerg. Med. Clin. North Am., 3, 117, 10.1016/S0733-8627(20)30912-3

Marr J, 1979, An epidemiologic study of the human bite, Public Health Rep., 94, 514

10.1016/S0196-0644(84)80604-6

Callaham ML, 1982, Human and animal bites, Top. Emerg. Med., 11, 1

10.1016/S0196-0644(82)80093-0

10.1016/S0196-0644(80)80335-0

10.1177/000992289002900506

10.1016/S0196-0644(05)82975-0

10.1016/S0378-1135(00)00186-3

10.1016/S0190-9622(89)70343-1

10.1111/j.1553-2712.1994.tb02442.x

10.1097/00005373-197903000-00014

10.1097/00005373-198020050-00004

Helm EB, 1972, Uber die Erreger bei infizierten Tierbissen, Munch. Med. Wochenschr., 114, 922

Douglas LG, 1975, Bite wounds, Am. Fam Physician, 11, 93

10.1016/S0361-1124(79)80339-1

10.1056/NEJM199901143400202

10.1097/00005792-198405000-00001

10.1097/00006534-198101000-00011

10.1016/S0363-5023(82)80013-0

Medeiros I, 2003, The Cochrane Library

10.1136/emj.6.4.251

Rodeheaver GT, 1975, Wound cleansing by high pressure irrigation, Surg. Gynecol. Obstet., 141, 357