Dog Bite to the Face
Animal bites can of course be scary, and even more so if to the face.
The majority will be caused by dog’s which is fortunate only in the sense that dogs have the LEAST infectious bite (only 5-20%).
A cat bite has almost a 50% chance of infection because they usually cause a puncture that penetrates deeply and closes quickly, thereby locking in the bacteria.
A human bite has a 25-30% chance of infection and is arguably the dirtiest bite containing the most bacteria but thankfully does not penetrate as deep as the cat.
It is VERY important that all bite injuries be washed out. Hydrogen peroxide and rubbing alcohol should be avoided as they can cause tissue damage. Mild soap and water or something like Shur-Clens if available, is preferred. Antibiotics, such as Augmentin, will help to further reduce the chance of infection.
Bites to the face should then be primarily closed to avoid scarring. It is equally important to note that you must put in sutures to reapproximate all layers, and not just the skin or it will fall apart or create railroad scarring.
Because most dog bite attacks happen to young kids and with dogs that they are familiar with, it is recommended that they not be left alone unsupervised. Kids are at particular risk because they are the same height as dogs and may play rough or not understand cues that the dog is not playing.
In my residency, I saw a lot of kids with dog bites to the face. A lot were disfiguring and some were even fatal.
Dogs in the household should be trained to know the hierarchy of the household. Things like walking through a door before the dog, or eating before them. If your dog has shown any inappropriate aggression please seek help with a trainer.
Lastly, an ENT or plastic surgery consult is a good idea as these bites or laceration could be hiding a nerve injury. The facial nerve, or nerve that controls movement to the face, runs along the face in a star like pattern to control movement to each section.
Sources:
- Rothe K, Tsokos M, Handrick W. Animal and Human Bite Wounds. Dtsch Arztebl Int. 2015 Jun 19;112(25):433-42; quiz 443. doi: 10.3238/arztebl.2015.0433. PMID: 26179017; PMCID: PMC4558873.
- Babovic N, Cayci C, Carlsen BT. Cat bite infections of the hand: assessment of morbidity and predictors of severe infection. J Hand Surg Am. 2014 Feb. 39(2):286-90.
- American Academy of Pediatrics. (2018). Dog bites: Information for parents. Pediatrics, 142(1): e20181042. doi: 10.1542/peds.2018-1042
- Mayo Clinic. (2021). Dog bite: First aid. Retrieved from https://www.mayoclinic.org/first-aid/first-aid-dog-bites/basics/art-20056525
