Укусы животных: виды, лечение и профилактика осложнений.

Wound or puncture caused by animal teeth

An animal bite is a wound, usually a puncture or laceration, caused by the teeth. An animal bite usually results in a break in the skin but also includes contusions from the excessive pressure on body tissue from the bite. The contusions can occur without a break in the skin. Bites can be provoked or unprovoked. Other bite attacks may be apparently unprovoked. Biting is a physical action not only describing an attack but it is a normal response in an animal as it eats, carries objects, softens and prepares food for its young, removes ectoparasites from its body surface, removes plant seeds attached to its fur or hair, scratching itself, and grooming other animals. Animal bites often result in serious infections and mortality. Animal bites not only include injuries from the teeth of reptiles, mammals, but fish, and amphibians. Arthropods can also bite and leave injuries.

Bites are usually classified by the type of animal causing the wound. Many different animals are known to bite humans.

A reverse bite injury (also called a clenched fist injury, closed fist injury, or fight bite) results when a person punches another person in the face, and the skin (and sometimes tendons) of their knuckles are cut against the teeth of the person they are punching. The proximity of the wound is often located over the metacarpophalangeal joint resulting in tendon injury. The medical treatment of this injury is similar to those of a human bite, but may also involve damage of the underlying tendons. These injuries should be managed as other human bites: wound irrigation and antibiotics are essential as human saliva can contain a number of bacteria. The nature of these injuries is such that even if the injury is optimally managed, poor outcomes may still occur. Rabies from other animals is rare. If there is a low risk of infection the wound may be sutured.

Antibiotics to prevent infection are recommended for dog and cat bites of the hand, and human bites if they are more than superficial. They are also recommended in those who have poor immune function. The first choice is amoxicillin with clavulanic acid, and if the person is penicillin allergic, doxycycline and metronidazole. Many diseases such as malaria and dengue are transmitted by mosquitoes.

Human bites are the third most frequent type of bite after dog and cat bites. Dog bites are commonplace, with children the most commonly bitten and the face and scalp the most common target. About 4.7 million dog bites are reported annually in the United States. The US estimated annual count of animal bites is 250,000 human bites, 1 to 2 million dog bites, 400,000 cat bites, and 45,000 bites from snakes. Bites from skunks, horses, squirrels, rats, rabbits, pigs, and monkeys may be up to 1 percent of bite injuries. Pet ferrets attacks that were unprovoked have caused serious facial injuries. Non domesticated animals though assumed to be more common especially as a cause of rabies infection, make up less than one percent of reported bite wounds. When a person is bitten, it is more likely to occur on the right arm, most likely due to defensive reactions when the person uses their dominant arm. Estimates are that three quarters of bites are located on the arms or legs of humans. Bites to the face of humans constitute only 10 percent of the total. Two thirds of bite injuries in humans are suffered by children aged ten and younger. Up to three fourths of dog bites happen to those younger than 20 years old. In the United States, the costs associated with dog bites are estimated to be more than $1 billion annually. The age groups that suffer most from dog bites are children 5 to 9 years old. Often, bites go unreported and no medical treatment given these bites go unreported. As many as one percent of pediatric emergency room visits are for treatment for animal bites. This is more frequent during the summer months. Up to five percent of children receiving emergency care for dog bites are then admitted to the hospital. Bites typically occur in the late afternoon and early evening. Girls are bitten more frequently by cats than they are by dogs. Boys are bitten by dogs two times more often than girls are bitten by dogs.

The bites of humans are recorded during the biblical era. Reports of secondary infection occurring after a human bite in children have been noted in the United States since at least 1910. Morbidity and mortality rates improved with the use of antibiotics.