Managing Bite Wounds in Small Animals

Pathophysiology of bite wounds:
Bite wounds exert shearing, distractive and compressive forces on the tissues. The amount of tissue injury is proportional to the energy absorbed by the injured body. Of the different forces applied the compressive (crushing) force imparts the greatest energy to the body and is responsible for the greatest damage. Sharp canine teeth can enter body cavities and damage deep structures, as discussed later, and are responsible for a direct inoculation of the oral bacterial flora into the injured tissues. Clearly, therefore, bite wounds can be immediately life threatening if they interfere with “critical” body systems such as the airway, heart, lungs, pleural space, spine etc but can also be threaten life by triggering systemic inflammatory response syndrome either because of massive tissue injury alone or secondary to rapid bacterial proliferation within damaged and devitalised tissues.

Overall treatment goals:
Because of the potential for damage to critical body systems in addition to damage to the subcutaneous tissues (in particular impairment of blood flow to damaged tissues) and the direct inoculation of microorganisms and often despite the apparently “minor” skin injuries, all bite wounds must be explored surgically. How quickly this is done and what order in which it is done will depend on the area of injury, the immediate or potential effect of that injury on survival and the overall stability of the patient. The clinician may, for example, have to focus on emergency airway provision in a critically ill patient that has been severely traumatised, and postpone surgical attention for other bite wounds until the animal is more stable.  [...]