What is a Human Bite?
The upper extremities and especially the hands are the most common site of human bites. Most people only think of one type of injury when the term “human bite” is used. An occlusive bite is what is typically brought to mind, which occurs when someone wounds or cuts the flesh of another using the teeth. Human bites also include clenched fist injuries which occur when the fist comes in contact with the teeth of another; and chomping bites, which may not break the skin of the hand, but may cause crush injuries to the tendons and bones beneath the skin. One type of bite often overlooked occurs when a person places their mouth on a wound sustained from a non-bite injury and sucks on it thereby introducing the bacteria of the mouth into the wound.
Human bites are often underestimated in severity by the lay public. While the wound itself may not look impressive, human bites have a propensity to become infected by the many species of bacteria that reside in the mouth, some of which can be difficult to treat. The hand is especially prone to infection due to its less robust blood supply and thin skin, giving bacteria easy access to deep structures. It is important that all human bites be evaluated by a medical provider.
What causes a Human Bite?
Closed fist injuries are the result of aggressive behavior leading to an altercation, usually in young males. Closed fist injuries can also result during participation in contact sports. Toddlers, with limited ability to express emotions, may bite out of anger and frustration. Mentally ill persons may engage in self-mutilating behavior that can include biting. Child abuse may be a possibility in children who present with bites.
What are the symptoms of a Human Bite?
A human chomp bite on the hand may present with the skin intact, and redness, swelling and tenderness. There may be limited range of motion of the hands and fingers if tendon damage or bone fracture has occurred. Occlusive bites and closed fist bites will present with a disruption in the integrity of the skin. This may range from a simple abrasion to a laceration to a deep puncture wound. Even if bleeding is not present, the skin barrier may have been broken and infection is a possibility if treatment is not started promptly.
How is a Human Bite diagnosed?
The history furnished by the patient and the symptoms described above will confirm the diagnosis of a human bite. It is important to note that some patients may be reluctant to admit the true cause of their injuries. These people must be reminded of the serious complications that may result if a human bite wound is not properly diagnosed.
Cultures of the wound may be useful to guide antibiotic therapy, and X rays may be useful to determine if any foreign body, including a tooth fragment, is present in the wound. X rays will also indicate a fracture that results from a clenched fist bite or occlusive bite.
How is a Human Bite treated?
Unfortunately, many people underestimate the severity of a human bite wound on the hand and attempt to self-treat their injuries at home. By the time they present to the emergency department or a doctor’s office, the hand has become infected. It is best to go directly to the emergency department when a bite wound is sustained.
Non-surgical treatments include a Tetanus booster if one has not been given in the past year, and risk assessment for transmission of infectious diseases at the time of injury. Although unlikely, a human bite could potentially transmit Hepatitis, Herpes infections, and HIV. If indicated, post-exposure prophylaxis can be given. Antibiotics will be prescribed to prevent or treat infection by mouth microorganisms.
Human bite wounds of the hand will be surgically explored and irrigated in the emergency department. First the wound is anesthetized with lidocaine, and once numb, is irrigated with an antiseptic solution. For proper cleansing to be achieved, the wound will most likely be opened further, allowing removal of blood clots and devitalized tissues which are a nidus for infection. Often, a hand surgeon will be called in for their expertise in avoiding the delicate structures present in the hand. If infection is already present in the hand, the patient will most likely be admitted for IV antibiotics.
How can Dr. Knight help you with Human Bites?
Human bites can present a very real danger to the patient, and Dr. Knight takes these injuries very seriously. He understands the risks of infection and complication in these delicate injuries, and will do everything in his power as surgeon to clear the hand of infection and regain full use of the appendage for the patient.
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