Earlier this week this tweet from @prsjournal caught my eye
Most Popular: Management of Horse and Donkey Bite Wounds: A Series of 24 Cases: No abstract available http://bit.ly/lgNkCS
Our experience shows the safety of primary closure for horse and donkey bite wounds, provided that careful debridement and good cleansing with antibiotic prophylaxis are also performed. An acceptable aesthetic outcome can be achieved only with early primary repair and reconstructive procedures.
- Thoroughly examine patients with bites. Especially with children, check the entire body to identify additional injuries.
- Examine the wound itself meticulously. It’s easy to miss things.
- Be alert for injuries to the vasculature, nerves, tendons, bones, and joints.
- Bites from large mammals can damage and even fracture bone. Plain radiographs should be viewed after the exam.
- Large mammals who bite and shake can dislocate joints. Have patients perform active range-of-motion with joints that are near bite wounds.
- Use plain radiography to assess for retained foreign bodies and skeletal injuries. Computed tomography and magnetic resonance imaging have increased sensitivity for foreign bodies and subtle fractures.