Bite wounds

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Bite wounds can be inflicted by an animal or another human. In milder cases, only the skin is injured. In the case of deep bite wounds, on the other hand, other structures are also affected, such as muscles, nerves or bones. Whether deep or not - every bite wound can become infected, as a wide variety of germs cavort in the saliva of animals and humans. Therefore, bite wounds should always be taken seriously. Read here how to provide first aid in the event of a bite wound.

Brief overview

What to do with bite wounds Clean, disinfect, cover sterile, if necessary a pressure bandage in the case of heavy bleeding, immobilize the injured part of the body in the event of snake bites, bring the affected person to a doctor or call emergency services.
Bite wound risks: wound infection, tissue damage (e.g. on muscles, nerves, tendons, vessels or bones); Symptoms of poisoning (when bitten by poisonous animals)
When to the doctor In principle, every bite wound should be examined by a doctor and treated if necessary.

Caution!

Even slight and seemingly harmless-looking bite wounds can become infected.
In the worst case, life-threatening blood poisoning, tetanus or rabies infection will develop!
A wound can become infected days after the bite. Therefore, observe bite wounds for signs of inflammation (swelling, reddening, overheating, etc.).

Bite wound: what to do?

In the case of bite wounds, the extent of the injury affects how properly treated. In principle, a distinction is made between three degrees of severity (according to Rueff et al.):

Superficial skin damage, scratches and scratches, possibly bruising
Deeper skin wounds up to the muscular skin (fascia), in the musculature or cartilage structures
Wound with tissue death (necrosis) or major tissue damage (substance defect)

However, it is hardly possible for laypeople to correctly assess the severity of a bite injury. Therefore, every bite wound should be viewed as an emergency and treated by a doctor. But first of all, first aid must be provided:

In the case of bite wounds that bleed little (e.g. from dogs or cats), you should clean the wound with water and a little soap.
Then disinfect the wound and cover it with a sterile cover.
If you have bite wounds that bleed heavily, you should apply a pressure bandage.
When a poisonous snake bites, you should immobilize the affected part of the body. Then any injected snake venom cannot spread through the body as quickly. Also remove tight-fitting clothing and jewelry near the wound (sleeves, rings, bracelets, etc.). The area around the bite wound can swell considerably.
Bring the patient to the doctor quickly or call the emergency services.

Types of bite injuries

Depending on who bites the animal, bite injuries usually show typical injury patterns. It also depends on the “perpetrator” how great the risk of a wound infection is.

Human bite

If a person bites, a ring-shaped impression with bruises and punctiform skin abrasions is usually left behind. There is a considerable risk of infection! An infected person can transmit AIDS pathogens (HIV) or hepatitis viruses (B or C) when they bite.

Cat bite

Cat bites are also very infectious. For example, they can cause blood poisoning (sepsis) or transmit rabies. A cat's bite typically leaves deep, punctiform wounds that hardly bleed. The tissue injuries can extend to the bone. When a cat bites the hand, finger tendons and joints are often affected.

You can read more about this in the article cat bite.

Dog bite

Dogs usually bite a person's hands and forearms, and in small children also the face. Often these are tears or bruises with a tattered edge. Since the animals have pointed teeth and strong jaws, deeper injuries to muscles, tendons, vessels, nerves and / or bones are not uncommon. Possible wound infections after a dog bite include blood poisoning and rabies.

You can read more about this in the article dog bite.

Rodent bite

Rodents such as rats, mice, guinea pigs, squirrels or rabbits usually only inflict superficial bite wounds. A wound infection is rare here (e.g. rabies, tularemia = rabbit plague, rat bite fever).

Horse bite

Due to the flat teeth of the animals, crush injuries (e.g. recognizable by the bruise) are characteristic.

Snakebite

Two bite points that bleed little are typical of a snakebite wound. If a venomous snake has bitten and injected poison, symptoms of poisoning of various types and severity can occur.

You can read more about this in the article Snakebite.

Bite wound: risks

The greatest danger with a bite wound is the high risk of infection. In addition, the attacker may have inflicted severe tissue damage on the victim. If a poisonous snake bites, there is also the risk of poisoning.

Bite wound: infection

The infection rate for cat and human bites is around 50 percent, and slightly lower for dog bites. Such wound infections originate from the many germs that are contained in the saliva of animals and humans and that can get into the wound when biting.

The risk of infection with bite wounds is also great because the injuries are often underestimated and then not properly treated. The risk is particularly high with very deep and soiled wounds and when the tissue has been severely damaged.

Depending on the pathogen, it can take a few hours to several days for the symptoms of the infection to show up. This can be, for example, redness, swelling and pain in the wound area. A purulent secretion may emerge from the wound. Fever and general malaise are other possible signs of wound infection.

Tissue damage

Slight bite wounds often only injure the superficial layer of skin (epidermis). In contrast, deeper bites can cause significantly more severe damage. For example, the skin can become detached from the tissue underneath (peeling / décollement). Nerves, blood vessels, tendons, muscles and / or bones are also often injured - sometimes with corresponding consequences. In the case of nerve damage, for example, the patient can no longer perceive temperature stimuli and touch as well in the affected area of the body (sensitivity disorders). Movement restrictions are also possible. Vascular injuries can cause bleeding into the tissue. In the worst case, a part of the body will be completely torn off by the bite, for example the hand or an ear.

Snake bite poisoning

Poison is not injected into the bite wound every time a poisonous snake bites. If this does happen, the health consequences it can have for the patient depend on the type of snake venom and the amount injected.For example, nerves can be damaged (for example with symptoms of paralysis), severe muscle pain and blood clotting disorders occur. The area around the bite site often swells and the patient develops circulatory problems.

Bite wounds: when to see a doctor?

You should always see a doctor with a bite wound. On the one hand, because only he can correctly assess the extent of the injury. On the other hand, because bite wounds can lead to wound infection. If necessary or advisable, the doctor can immediately give the patient a vaccination against tetanus or rabies.

Bite wounds: medical examinations

In a conversation with the patient or accompanying person, the doctor will first try to get an idea of the course of the injury and the bite wound (anamnesis). For example, he asks whether the animal has behaved abnormally (suspected rabies) and - in the case of pets - whether it has been vaccinated against rabies. The doctor should also be informed about a known immune deficiency in the patient (e.g. in the case of diabetes or cortisone therapy) and the use of medication (such as blood thinners).

This is followed by a physical examination. Among other things, the doctor checks how deep and dirty the wound is and whether there are any signs of inflammation. Often he will also take a blood sample, among other things to have it checked for signs of infection. A wound swab can also be very informative: any wound germs can be detected in the laboratory.

If there is a suspicion that the bite wound is associated with bone injuries, imaging procedures (e.g. X-rays) provide clarity.

Bite wounds: Treatment by the doctor

The doctor will thoroughly clean and rinse minor bite wounds (again). Then it closes, for example with plasters, staples or sutures (primary wound care).

Deep and infected wounds, on the other hand, are usually kept open for a while and cleaned several times before they are closed (secondary wound care). This is used to prevent an infection or to eliminate an existing infection first.

If necessary, the doctor will remove damaged, dead or infected tissue from the wound area before the wound is closed (debridement).

The doctor can prescribe an antibiotic as a preventive measure for patients with deeper bite wounds. This lowers the risk of wound infection. In addition, the doctor will give a rabies and / or tetanus vaccination if the patient does not have vaccination protection and there is a corresponding risk of infection. Since the rabies vaccination is time-consuming and stressful for the person concerned, an attempt is usually first made to determine the vaccination status of the person who caused the bite (human or animal).

Patients with a snakebite are often treated as inpatients. The injured part of the body is immobilized.

Prevent bite wounds

Bite injuries are common. Usually it is dogs that bite, more rarely cats, horses, rodents or other people. As for animal attackers, there are several things you can do to prevent bite wounds:

Do not behave threateningly or aggressively towards dogs, cats and other animals, but rather calmly and defensively. This also applies to dealing with otherwise peaceful pets.

Learn how to correctly interpret warning signs from animals.

Do not touch an animal when it is eating or has young.

Never approach an animal silently and / or from behind. Otherwise it could startle and bite.

Avoid fast movements and loud noises around an animal.

Show children right from the start how to handle animals correctly (e.g. do not pull on the fur / tail, do not drag around like a toy, do not be frightened).

Wear sturdy shoes and long pants when walking in an area with snakes. Also use a walking stick - the vibrations when it hits the ground warn the animal, so that it usually warps.

If you take these measures to heart, you can reduce the risk of bite wounds when handling animals.

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