Disclaimer: The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature.Human And Animal Bite Wounds Of The Head And Neck Case Presentation: The patient is a 33-year-old African-American veteran who sustained a bite wound to the upper lip while involved in a street altercation. The bite injury resulted in a significant soft tissue loss with approximately 33% of the upper lip missing. The patient did not seek treatment initially, but presented to the ER 48 hours after the injury with an erythematous, tender wound. There was no gross purulence, but the wound was obviously infected. The patient had no medical problems and there were no other compounding factors. The patient was admitted to the hospital and started on IV Unasyn. His wound was irrigated and minimally debrided. On hospital day three, he was taken to the operating room, where he underwent closure of his lip wound with a fan flap, and mucosal advancement. Post-operatively, he had minimal tissue loss at the inferior edge of the flap, which healed well by secondary intention. With return of his mustache growth, his scar is essentially unnoticeable. He has had full functional recovery and is satisfied with his cosmetic result. Bibliography: Agrawal K, Mishra S, Panda KN. Primary reconstruction of major human bite wounds of the face. Plast Reconstr Surg 1992;90:394-398. Bernstein L, Nelson RH. Replanting the severed auricle. Arch Otolaryngol 1982;108:587. Boland FK. Morsus humanis. JAMA 1941;116:127-131. Boyce FF. Human bites. South Med J 1942;35:631. Brandt FA. Human bites of the ear. Plast Reconstr Surg 1969;43:130-134. Brook I. Microbiology of human and animal bite wounds in children. Pediatr Infec Dis J 1987;6:29-32. Brooks GF, O'Donoghue JM, Rissig JP, et al. Eikenella corrodens, a recently recognized pathogen. Medicine 1974;53:325-342. Clemons JE, Connelly MV. Reattachment of a totally amputated auricle. Arch Otolaryngol 1973;97:269-272. Curtin JW, Greeley PW. Human bites of the face. Plast Reconstr Surg 1961;28:394-396. Earley MJ, Bardsley AF. Human bites: a review. Br J Plast Surg 1984;37:458-462. Feder HM Jr, Shanley JD, Barbera JA. Review of 59 patients hospitalized with animal bites. Pediatr Infect Dis J 1987;6:24-28. Goldstein E. Human Bites. In: Mandell GL, Douglas RC, Bennett JE, editors. Principles and Practice of Infectious Diseases, 3rd Edition. New York: Wiley; 1990. pp834-836. Goldstein EJ, Caffe HH, Prive JE, Citronbaum DM, Miller TA, Finegold SM. Human bite infections. Lancet 1977;2:1290. Goldstein EJ, Citron DM, Wield B, Blachman U, Sutter VL, Miller TA, et al. Bacteriology of human and animal bite wounds. J Clin Microbiol 1978;8:667-672. Goldstein EJC, Richwald GA. Human and animal bite wounds. AFP 1987;36:101-109. Laskin DM, Donohue WB. Treatment of human bites of the lip. J Oral Surg 1958;16:236-238. Leung AKC, Robson WLM. Human bites in children. Pediatr Emer Care 1992;8:255-482. Losken HW, Auchincloss JA. Human bites of the lip. Clin Plast Surg 1984;11:773-775. Lowry TM. The surgical treatment of human bites. Ann Surg 1936;104:1103. Mladick RA. Salvage of the ear in acute trauma. Clin Plast Surg 1978;5:427-435. Mladick RA, Carraway JH. Ear reattachment by the modified pocket principle. Plast Reconstr Surg 1973;51:584-587. Musgrave RH, Garrett WS. Dog bite avulsions of the lip: a conservative concept. Plast Reconstr Surg 1972;49-294-296. Neiva J. Early rotation of a cross-lip flap to repair a defect caused by a human bite. Plast Reconstr Surg 1979;64:558-559. Rest JG, Goldstein EJC. Management of human and animal bite wounds. Emerg Med Clin North Am 1985;3:117-126. Shields C, Patzakis MJ, Meyers MH, et al. Hand infections secondary to human bites. J Trauma 1975;15:235-236. Spinelli HM, Sherman JE, Lisman RD, Smith B. Human bites of the eyelid. Plast Reconstr Surg 1986;78:610-14. Stucker FJ, Shaw GY, Boyd S, Shockley WW. Management of animal and human bites in the head and neck. Arch Otolaryngol Head Neck Surg 1990;116:789-793. Tomasetti BJ, Walker L, Gormley MB, Berger J, Gold BD. Human bites of the face. J Oral Surg 1979;37:565-568. Turpin IM. Microsurgical replantation of the external ear. Clin Plast Surg 1990;17:397-404. Uchendu BO. Primary closure of human bite losses of the lip. Plast Reconstr Surg 1992;90:841-845. Venter THJ. Human bites of the face. S Afr Med J 1986;74:277. Weinstein RA, Stephen RJ, Morof A, Choukas NC. Human bites: Review of literature and report of a case. J Oral Surg 1973;31:792-794. Click here to view slides from this presentation (pdf file). Grand Rounds Archive | Department Home page BCM Public | BCM Intranet | Privacy Notices | Contact BCM | BCM Site Map | ©2001-2005 Baylor College of Medicine
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