Treatment | Mammalian Bites In The Emergency Department: Recommendations For Wound Closure, Antibiotics, And Postexposure Prophylaxis

<< Mammalian Bites in the Emergency Department: Recommendations for Wound Closure, Antibiotics, and Postexposure Prophylaxis (Trauma CME and Pharmacology CME)


Wound Care And Repair

General Concepts

Irrigation of a bite wound can significantly reduce the risk of infection. High-pressure irrigation de¬creases bacterial counts of wounds and decreases wound infection rates compared with low-pressure irrigation.34 High-pressure irrigation can be achieved by attaching a 16- to 19-gauge catheter to a 35- to 65-mL syringe. Normal saline or tap water can be used as the irrigation fluid. A 2012 Cochrane review found no difference in infection rates with normal saline versus tap water.35 Irrigation with povidone-iodine is generally not recommended because it is toxic to fibroblasts and, theoretically, could cause issues with wound healing.36,37 However, in cases where rabies or HIV infection is of concern, a 1% solution of povidone-iodine may be used, since it has virucidal properties.

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