Irrigation using sterile saline, sterile water or tap water with adequate pressure is required to prevent infection/contamination of wounds. Additionally, debridement of devitalized tissue, debris, and clots prevent the injury site from becoming a source of infection.
In general, dog bites to the hand and lower extremity that are more than 8 hours old and dog bites in immunocompromised patients should be left open or treated by delayed closure. If available, specialist consultation can be considered to assist with the decision to close.
Approximately 16 different bacteria are common in dog bites. In order to cover the most common pathogens (and absent contraindications), amoxicillin-clavulanate is the oral antibiotic of choice. First line intravenous counterparts to this oral antibiotic include ampicillin-sulbactam, ticarcillin-clavulanate, piperacillin-tazobactam, or a carbapenem.
Dog bite infections medical expert witness specialties include infectious disease, pediatric infectious disease, pediatric plastic surgery, plastic surgery, and veterinary medicine.