5.14 Surgical Trauma Wound Management Bites (Tintinalli)

Front 1

In regards to Animal bites, which of the following is correct ?
A. Cat bites account for the majority of animal bites.
B. up to 60% of cat bites become infected.
C. Dog bites are usually polymicrobial.
D. Pasteurella multocida infection in cat bites is a slowly developing infection.

Back 1

C.

A = Dog bites (80-90%)
B = 80%
D = rapidly developing inflammation and infection.

Front 2

What are the mainstays of dog bite treatment ?

Back 2

1. Copious wound irrigation and debridement of devitalised tissue.
2. Antibiotics
3. Primary, or delayed primary closure of wound.
4. tetanus update

Front 3

In which cases of dog bite is infection more common ?

Back 3

1. Age > 50
2. Hand wounds
3. Deep puncture wounds
4. Delay in seeking initial treatment

Front 4

In regards to animal bites, which of the following % is incorrect ?
A. Infection occurs in 5% of dog bites.
B. Cat bites make up approximately 5-18% of all bites.
C. Pasteurella multocida is isolated in 90% infected cat bites.
D. Dog bites account for 80-90% of all animal bites.

Back 4

C. 53-80%

Front 5

Which of the following is not considered an appropriate antibiotic for the management of High risk Dog bites ? [ for 3-5 days ].
A. Amoxycillin-clavulanate
B. Clindamycin + Ciprofloxacin
C. Trimethoprim-sulfamethoxazole + Clindamycin in penicillin-allergic patients.
D. Doxycycline

Back 5

D. Doxycycline used for prophylaxis in cat bites

Front 6

In regards to Cat bite management, which of the following is incorrect ?
A. Primary wound closure is usually recommended.
B. All patients should receive prophylactic antibiotics.
C. Penicillin is the drug of choice for established infection (by Pasteurella multocida).
D. Delayed primary closure is considered when patients present > 12 hours post bite.

Back 6

D. 6 hours.

Front 7

What factors favour delayed primary closure OR avoiding simple primary closure in cat bites ? (4)

Back 7

1. Presentation beyond 6 hours
2. Lack of cosmetic concern
3. Requirement for complex repair
4. Underlying injury requiring Surgical intervention.