ANIMAL BITE WOUNDS: SUTURING OR NOT? A SYSTEMATIC REVIEW
Dimitrios Xythalis
Friday, January 1, 2021
Publication year:
2021
Author:
- Xythalis Dimitrios, Registered Nurse, Med, MSc, General Hospital of Athens «Sismanoglio-Amalia Fleming»
Keywords index:
Pages: 51-61
Abstract:
Introduction: Mammalian bite wounds consist a frequent, as well as an important health problem worldwide, with high health care cost and spending. Complications due to bites often involve injury of soft tissues and wound infection. Treating of bite wounds includes surgical treatment of the wound while the need for suturing or not the wound is a controversial issue. Aim: The purpose of the present study was to investigate whether suturing bite wounds is advantageous regarding infection possibility and wound healing degree. Methods:Searching was conducted in Pubmed and Scopus electronic databases using «animal bites», «bite wounds», «suture», «closure» as key-words to locate published 1988 studies up to 2017. When inclusion and exclusion criteria were applied, 57 studies typically included titles and abstracts of potentially relevant researches, which were further evaluated and reduced to 11 research studies that were finally eligible for systematic review. Results: None of the studies supported any statistically significant difference between wound suturing and overall increase of infection incidence, provided that irrigation and debridement were applied when necessary. Two studies revealed statistically significant increase in infection incidence of upper extremities, whether wounds were sutured or not. Wound healing was reported significantly better in two studies based on scarring, length of the healing process, whilst aesthetic result was very good. Conclusion:Current evidence is insufficient to make recommendations regarding whether bite wounds should be sutured or not. Possibly, they could be sutured more often, only under certain conditions and if the overall cosmetic appearance predominates over the risk of infection.Either way, wound care strategies have to involve meticulous cleansing and tissue debridement, regardless wound size and clinical decision on suturing it or not.
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