Pediatrics- Bite Injuries, Animal Bites

The hand consists of multiple bones that form the structure of the wrist and fingers. These bones are connected by robust ligaments. Tendons, which are strong fibers, link muscles to bones, facilitating movement. The hand also houses nerves, blood vessels, and fat. The skin covering the hand serves as a protective barrier against environmental hazards.

Animal bites most commonly occur on the hand, leading to skin lacerations, puncture wounds, crushed bones, and torn ligaments, tendons, or muscles. Additionally, blood vessels and nerves can sustain injuries. Infections, including rabies, can be transmitted through bites, complicating the injuries.

Dogs, with their strong jaws and rounded teeth, can inflict crushing injuries, while cats tend to create more puncture wounds due to their sharp, pointed teeth. Infections resulting from animal bites are often mixed, involving various bacteria, viruses, fungi, and other pathogens. Rabies remains a critical concern, especially as untreated rabies can be fatal; however, most pets in the U.S. are vaccinated against it, with the majority of rabies cases stemming from wild animals such as skunks, bats, and raccoons.

Dogs are the leading cause of animal bites, followed by cats. Stray and wild animals, including skunks, raccoons, foxes, bats, rodents, reptiles, and farm animals, may also bite if they feel threatened or provoked. If an animal bites your child, keep the animal in sight and contact local animal control to capture it. They can quarantine the animal and check for rabies, as well as verify the rabies vaccination status of stray pets.

Animal bites can lead to pain and swelling, making it difficult for your child to move their fingers or wrist if bones, muscles, tendons, ligaments, or nerves are affected. Symptoms may include loss of sensation or tingling in the fingers. Inspect the hand for puncture wounds and bleeding. Signs of infection include warmth, redness, pain, tenderness, and potential pus drainage from abscesses. Infections can also cause fever, chills, or sweats.

If your child is bitten, wash the wound thoroughly with soap and water unless it is actively bleeding. In cases of bleeding, apply direct pressure with a clean cloth and elevate the hand above the heart. Seek immediate medical attention for significant bleeding.

Inform your doctor about the type of animal involved and how the bite occurred. A physical examination of your child's hand and arm will be performed, and an X-ray may be necessary if structural damage is suspected. The doctor will clean the wound thoroughly, removing any foreign materials, and may order a blood test to check for infections. A tetanus shot and antibiotics may be administered to prevent infection. If rabies is suspected, your child will receive a series of vaccinations, which are most effective if administered early. Always seek prompt medical attention for animal bites.

Animal bites that penetrate the skin require thorough cleaning. Typically, such wounds are left open rather than stitched to minimize infection risk. If an infection is present, your child may be prescribed antibiotics, topical ointments, or IV antibiotics. The wound will be loosely bandaged, and your doctor will provide specific home care instructions. It is vital to attend all follow-up appointments to monitor your child’s healing progress.

Surgery may be necessary if the bite has damaged bones, blood vessels, muscles, tendons, ligaments, or nerves or if an abscess forms. The type of surgery performed will depend on the nature and severity of the injury. After surgery, your child will likely require hand therapy to help restore the structure and function of their hand.

Recovery from animal bites varies based on the injury's extent and the treatment received. Your doctor will provide guidance on what to expect during recovery. It’s important to attend all doctor and therapy appointments to ensure the best possible outcome.