Animal & Human Bites

Tetanus Toxoid Intravenous Antibiotics Posi Z-Splint (Position of Safe immobilisation Splint) Elevation of the Limb


Initial Management

  1. All bites that penetrate the skin are surgical emergencies and will require surgical debridement.
  2. Keep patient fasted
  3. Initiate early intravenous antibiotic treatment. Augmentin is generally a good antibiotic to cover gram positive and anaerobes. Use Clindamycin if penicillin allergy.
  4. Irrigate wounds with saline and cover with basic vaseline gauze (jelonet) dressings before it is covered and splinted.
  5. Immobilise the affected limb in a POSI (position of safe immobilisation) splint prior to admission.
  6. Order elevation in a pillow slip of the affected limb.
  7. Order x-rays of the injured zone, especially if it was a big dog and with bites involving the hand and fingers.


Rehabilitation

  1. Rehabilitation is individualised based on the extent and structural involvement of the injury.
  2. Initial management is oedema management and appropriate splinting.
  3. Early mobilisation is crucial to prevent scar adhesions, tightness and stiff joints.
  4. Strengthening of the affected limb will follow.