Case study ( 2094 views as of January 24, 2019 )
Jianguo is a 33-year-old entrepreneur who provides home maintenance services, such as gutter cleaning, power-washing, and window cleaning. He was working on a job at a new client's home, and the homeowner let her dog out into the yard, forgetting that Jianguo was there. While stepping down from his ladder, Jianguo was bitten by the dog on his right calf.
Jianguo was brought to the emergency department by his client, despite Jianguo insisting that his injury was "nothing". He had two small puncture wounds and one small tear in his skin. The emergency physician ensured that there was no injury to the underlying tendons, blood vessels and nerves. The doctor also ruled out any foreign material in the wounds. Jianguo's right calf was frozen with local anesthetic, irrigated and covered with a bandage. The wounds were small, and suturing (stitching) was discussed. Jianguo elected not to have sutures, as he felt the infection risk would be higher if the wound was closed.
Dog bites will sometimes (~20% of the time) become infected, but with good local wound care, they often heal well on their own. Jianguo will benefit from having the wound followed by his primary care provider. He will also need to get some wound care supplies, and may benefit from a topical antibiotic or wound care ointment from his local pharmacy or medical supply store.
More severe wounds may require evaluation and care by surgical specialists. Some larger dogs have very powerful bites, and may cause more significant soft tissue damage, and damage to more important underlying structures.
Rabies is a common question that people with animal bites ask about. Rabies is uncommon in North America, but review of immunization history of the patient and the animal (if known) is an important consideration in bite wounds.Author: Dr. Adam Lund