Today we talk to Zoë Halfacree, senior lecturer in soft tissue surgery here at the RVC, about bite wounds and some things to consider in how to approach them, after initial patient assessment and stabilisation.

·      Analgesia; full mu opioid based upon pain score

·      Antibiotics; broad spectrum, such as potentiated amoxicillin

·      Culture where possible

·      Diagnostic imaging

·      When to explore; preferably within 4-6 hours of presentation

·      Lavage techniques; isotonic crystalloid (e.g. compound sodium lactate) using a 25ml syringe and 19-gauge needle. If you attach the fluid bag to an extension set and that to a three-way tap, with the needle and syringe, if makes it a little easier to flush.

·      Wet to dry dressing vs placing a drain

 

Zoë discussed these aspects of bite wound management. Although this is a relatively common problem that we encounter, there is little information in the literature to help guide us on ways to manage these challenging patients.

Enjoy!

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