27. Managing Animal Bites in Children

BASIC FIRST AID FOR ANIMAL BITES

If your child is ever bitten by a dog, cat, or any other animal, start by cleaning the wound thoroughly with soap and water. Inspect the wound for dirt and foreign objects, which should be removed. Running water over the wound from the sink or bathtub may be helpful. An over-the-counter topical antibiotic, such as bacitracin, can be applied once the wound is clean. Sterile gauze can be used to cover a wound, but gauze shouldn’t be applied too tightly, as this can increase the risk of infection. Most wounds heal better if they’re allowed to breathe.

WHEN TO SEEK MEDICAL ATTENTION

Under some circumstances, bite wounds will require medical attention. In general, because animal mouths are dirty, bite wounds are at high risk for infection. It is better, therefore, not to close a bite wound with stitches if it can be avoided. However, bite wounds which are gaping open or located in cosmetically important areas, such as the face, may need to be closed with stitches.

Importantly, all lacerations will scar, to some degree, whether or not they are closed with stitches; therefore, the risks and benefits of closing a bite wound must be carefully weighed.

When necessary, stitches should be placed as quickly as possible. The more time that passes, the higher the risk of infection. Arm and leg wounds should ideally be closed within 6-12 hours, and wounds on the face should be closed within 12-24 hours.

Antibiotics are sometimes necessary following an animal bite wound to prevent infections. Here are some circumstances in which antibiotics may be prescribed:

1. A bite wound has just been closed with stitches.
2. A bite wound is moderate to severe.
3. A deep puncture wound has occurred.
4. The bite involves bone, tendon, or joints.
5. The bite involves the face, hands, feet, or genitals.
6. The victim is immunocompromised.
7. The child was bitten by a cat; almost all cats bites are true puncture wounds.

Children who need antibiotics following a bite wound are usually treated with Augmentin. Those who are allergic to penicillin can be treated with a combination of Bactrim and clindamycin.

Importantly, the risk of rabies should be immediately assessed and managed for any child who receives an animal bite. Please consult your pediatrician regarding the need for rabies prevention when an animal bite occurs.