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Emergency Medicine Journal 2007;24:455-458; doi:10.1136/emj.2006.045054
© 2007 BMJ Publishing Group Ltd, and British Association for Accident and Emergency Medicine

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ORIGINAL ARTICLE

The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon

Francis P Henry, Elizabeth M Purcell, Patricia A Eadie

Department of Plastic, Reconstructive and Hand Surgery, St James’s Hospital, Dublin, Ireland

Correspondence to:
Correspondence to:
Francis P Henry
One Emerson Place, Apt 7A, Boston, MA 02114, USA; fhenry{at}rcsi.ie

Background: Human bite injuries are both deceptive and challenging in their presentation and management. They remain a frequent presentation to our unit, most often following late night alcohol fuelled aggression.

Aims: To audit the management of these wounds, with particular focus on infective complications and outcomes.

Methods: A three year retrospective chart review was undertaken on all patients referred to the plastic surgery unit from 1 January 2003 through to 31 December 2005.

Results: A total of 92 patients with 96 human bite wounds were identified. The majority were male (92%). Alcohol consumption was documented in 86% of cases. The majority (70%) occurred over the weekend or on a public holiday. Facial injuries made up 70% of injuries with the remainder being to the upper limb. The ear was the most common target of all facial injuries (65%). Infection was documented in 18 cases (20%), with bite injuries to the upper limb and those presenting late (>12 h) having a higher incidence of infection.

Conclusions: Human bite wounds present a challenge to any emergency department, given the many issues involved in their management. Underestimation of the complexity and potential sequelae of these wounds will result in a suboptimal outcome for the patient.





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The Importance of Irrigation
Daniel G Boden
EMJ Online, 29 Jun 2007 [Full text]



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© 2007 BMJ Publishing Group Ltd, and British Association for Accident and Emergency Medicine