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Bites - human and animal - Management
When should I refer someone with a human bite?
- Refer to secondary care:
- Penetrating wounds involving arteries, joints, nerves, muscles, tendons, bones, or the central nervous system. Note: penetrating bites to the hands or feet are at particular risk of infection and serious complications.
- Facial wounds (excluding very minor wounds).
- Bites where there is a possibility of a foreign body (e.g. a tooth) in the wound.
- Devitalized wounds where debridement is required.
- Bites where the severity of the injury is difficult to assess.
- People with severe cellulitis, or with infected bite wounds that are not responding to treatment, or who are systemically unwell.
- People with an increased risk of infection — including those with diabetes or cirrhosis, those who are immunocompromised, and asplenic individuals (especially if they are not taking prophylactic penicillin).
- Injuries requiring reconstructive surgery.
- Bites to poorly vascularized areas e.g. ear cartilage/nose cartilage.
- If adult bites have been inflicted on a child, consider child protection issues. Follow local policies for referral of children considered at risk.
In depth
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