2009 September

Archive for September, 2009

Web Log - September 2009 - Dog Bites

Tuesday, September 1st, 2009

Caldwell Night Rodeo - Saddle Bronc Rider

We are fortunate to live in a nice part or the country / world that has little major trauma. This fact is particularly appreciated by my Plastic Surgical colleagues and I who take city wide one day in six call to the Emergency Department. Providing care is required by St. Luke’s and St. Alphonsus for maintaining hospital priveleges and is considered a public service. Occasionally, however, we see some bad injuries. Some of the most heart breaking are dog bites to children. A recent visit to the ER to treat a child and a paper in the August issue of our main journal lead me to blog on the problem.

The study in the journal documented injury patterns in a Philidelphia hospital. The following is a summary of the findings: 62% of bites were to boys; 24% of the bites occurred in June and July; 51% of bites were in 6-12 year olds and 24% in 2-5 year olds; young children had more face bites at 54% while older ones had more extremity ones at 61%; the breed of only 30% of the offending dog was documented, but of these, 51% were pit bulls, 9% rottweilers, and 6% mixed pit/rotty.

So what does this tell us? There are some demographic patterns, but any child of any age may be bitten anywhere by any dog at any time. One may also conjecture that dogs seem to attack little kid’s faces because they may be seeing them eye to eye. As for the breeds, 30% documentation of type is poor, but it is hard to ignore that two thrids of the bites were due to pit bulls, rottweilers, or a mix of the two. Perhaps because these breed cause more significant injuries, my own experience in 10 years of Plastic Surgery ER call is greater than 90% pit or rotty- German Shepards and various others make up the rest. Now, the last thing I want to do is be controversial, start a fight, or be accused of profiling. These are usually lovely dogs with devoted owners and the offending dogs may have been mistreated or provoked. Dogs, like people, should be treated as individuals. Please, no angry mail.

Considering the presented information, I have a few recommendations. All dogs should be treated with respect and kindness. Pit bulls and rottweilers deserve love too - with a little extra caution, just in case. Unfamiliar dogs should be avoided. Stay away from dogs while they are eating and when they are feeling scared or threatened. Small children are particularly vulnerable to devastating injuries which will scar them for a lifetime, so a healthy dose of paranoia ( or a little more in my case ) is indicated. Not every dog bite needs a plastic surgeon and the ED physicians are competent to take care of most. If they want help, they ask for it. All bites are at high risk for infection and should be thoroughly washed out and treated with oral antibiotics. Extremity wounds are often left open, but facial wound are usually closed loosely to allow drainage while still allow some cosmetic improvement ( with about a 5% infection rate).

You don’t have to send your kids out in full body armour like I do, but encourage your little loved ones to be careful out there.