Bisswunde

Bisswunde, or bite wound, is a wound caused by the teeth of an animal or human. These injuries can range from superficial punctures to deep lacerations and crush injuries, and they are often contaminated with oral flora. Bite wounds may involve skin, soft tissue, and, in severe cases, tendons, joints, or bones. They occur on any part of the body but are commonly seen on the hands, face, and feet.

Causes and presentation vary with the type of bite. The most frequent sources are dogs and cats, followed by human bites; bites from other animals can occur as well. Immediately after impact, pain, bleeding, and swelling are common. Infections can develop quickly due to oral bacteria, with Pasteurella species common in animal bites and Eikenella corrodens associated with human bites. Delayed infection signs may include increasing redness, warmth, fever, or systemic symptoms.

Management begins with thorough wound care: irrigation with saline, potential debridement, and assessment for depth and involvement of tendons, joints, or bones. Imaging may be warranted for deep or hand/wrist injuries. Tetanus status should be checked, and rabies risk assessed if the animal is unknown, wild, or cannot be observed. Wounds on the hands or face and puncture wounds have higher infection risk and require careful management.

Antibiotics are commonly used for many bite wounds, especially on the hands or when there is a higher risk of infection. First-line therapy is amoxicillin-clavulanate; alternatives include doxycycline or a combination suitable for penicillin allergy. Prophylaxis is typically considered for high-risk bites, immunocompromised individuals, and suspected deep or contaminated wounds.

Wound closure is typically delayed to reduce infection risk, though certain facial wounds in selected cases may be closed after thorough cleaning by an experienced clinician. Follow-up is important to monitor healing and signs of infection. Prevention includes vaccination updates (tetanus) and, when applicable, rabies considerations. Overall prognosis depends on wound severity, contamination, and prompt, appropriate treatment.