We discovered that the usage of sterile adhesive whitening strips is a less traumatic and more desirable option, which may be very good for high\risk wounds in the face region. those that presented towards the outpatient medical clinic ( 005). The primary concern in the administration of pet\inflicted wounds is normally their prospect of an infection, but this will not imply that every wound will be infected. The main factor has been able to distinguish wounds that have a greater potential for contamination and to select the type of wound management accordingly. An algorithm has been proposed as a guidance for the management of AIOWs, which covers the approach towards both domestic and stray animal\inflicted injuries. value MRS1177 less than 005 was considered statistically significant. Results A total of 205 patients were admitted to the emergency department for the treatment of animal\inflicted wounds. The mean age of the patients was 259 years (2C88 years), with 153 of them being male and 52 being female. Doggie bites accounted for 69% (142 patients) of the wounds, whereas cattle/horse kick and horn\inflicted injuries were a much second with 13% (26 patients) and cattle/horse bite wounds were third with 9% (19 patients) (Table ?(Table11). Table 1 Characteristics of the patients presenting to the emergency department for animal\inflicted open wounds Patient demographicsNumber of patients205Male/female153/52Age259 years (2C88 years)CausesDog bite142 (69%)Cattle\horse kick, horn26 (13%)Cattle\horse bite19 (9%)Wolf bite7 (3%)Cat bite7 (3%)Fox bite2 (1%)Bear bite2 (1%)Location of injuryHeadCneck23 (11%)Hand8 (4%)Extremities85 (41%)Stomach, back, buttock89 (43%) Open in a separate window Following initial evaluation, 18% (36 patients) of these patients presented to plastic surgery. The mean age of the consulted patients was 218 years (3C54 years) and 26 of them were male. Twenty\four patients consulted for bites, while 12 were kick\inflicted patients. All patients who were referred to plastic surgery experienced open wounds that were either located on the head and neck region or were injuries that penetrated to deeper tissues or resulted in tissue defects. After obtaining the patient’s history and following a thorough physical examination for possible coexisting injuries, all wounds were treated with the general protocol that has been adopted by the emergency department, which consists of inspection, copious irrigation, debridement and closure under indicated circumstances. After inspecting the wound to identify the depth of tissue injury and to note if there is involvement of nerve, vessel, muscle mass or tendon damage, irrigation was carried out generously with saline answer. After the removal of all foreign materials and Rabbit Polyclonal to Lamin A (phospho-Ser22) adequate irrigation, the wound was further inspected to note whether any necrotic or non\viable tissue was present. If surgical debridement was to be carried out especially in the headCneck region, plastic surgery was consulted. Main closure was generally chosen for patients who experienced early presentation (within the first hours of injury), with wounds that could be effectively irrigated and debrided, with no apparent indicators of contamination or tissue loss (67%, 137/205). Stray doggie and wild animal bites were approached more cautiously for such cases, and sometimes delayed closure was favored, which will be further discussed. Patients who offered 7C8 hours after the onset of injury, patients who experienced indicators of wound contamination or patients who suffered from wounds that were prone to contamination, such as a penetrating cat bite or wounds that were located in areas anatomically prone to contamination, for example hands were not sutured primarily (33%, 68/205). Instead, intensive wound care was adopted for these patients with daily follow\ups, and closure was planned after the risk of contamination was ruled out. Vacuum\assisted closure was used in two patients who presented with soft tissue defects on their extremities in order to promote healthy granulation tissue prior to surgery. Patients who experienced tissue loss as a result of animal\inflicted injuries were hospitalised in order to be closely observed until granulation tissue was sufficient enough for proper coverage, either with local flaps or skin grafting. Most dilemmas were encountered while chosing the optimal wound closure in patients who experienced suffered from AIOW located on the head and neck region, and plastic surgery was considered for all of these patients as well. Although wounds MRS1177 tend to heal very well in this area due to high vascularity, wounds MRS1177 that were inflicted directly by bites from animals of unknown origin or wounds that experienced a large surface area were.