Dog Bite Puncture Wounds: Care & Signs of Infection

Instructor: Lisa Cauthen

Lisa is a Registered Nurse with a 14 years of experience and a Masters Degree in Nursing Education. She has certifications in CPN, ACLS, PALS, and NRP.

Dog bites can cause puncture wounds and should be treated promptly to cleanse and close the wound and to provide infection prevention. In this lesson, we will review the care of a dog bite puncture wound and the signs of infection that may indicate that further medical care is necessary.

Dog Bite Puncture Wounds: Care and Signs of Infection

Your neighbor's daughter Christa just came running to you crying and holding out her bleeding hand. ''What happened!?'' you ask? ''The doggie bit me,'' she says between sobs. You look and see several deep puncture wounds in her hand. What dog, you wonder? And what do you do now?

Regardless of the size of the wound or the dog that bit her, Christa needs to be seen by a medical professional who can provide closure of the wound and antibiotics. Unless contraindicated, antibiotics are always prescribed in the event of a dog bite to prevent infection from the bacteria that are found in dogs' mouths.

Dog Bite Wound to Hand

Closure and Care of the Wound

Prior to closing the wound, a thorough cleaning of the wound is important to remove as much debris and bacteria as possible. This can be done with soap and water, a medical solution such as Hibiclens, or normal saline irrigation. Used well, they are equally effective. Closure of the wound should be performed with either sutures (stitches) or staples to allow drainage to leave the wound. A dog bite should never be closed with skin glue, such as Dermabond, which could trap bacteria and debris in the wound.

Following closure of the wound, care should be taken at home to promote healing by keeping the wound clean and dry and by applying antibiotic ointment as advised by the medical provider.

Signs of Infection

With all dog bites, there is a concern for infection due to the uncleanliness of a dog's mouth. This is why antibiotics are indicated. However, even with appropriate cleansing, closure, and treatment, the wound can still get infected; so it is important to monitor for infection of the wound.

Signs of an infected wound can be local or systemic. Local signs of infection are found near the area of the wound and can include erythema (redness) and heat as a result of increased blood flow to the area. Swelling can occur as fluids accumulate around the wound and is usually accompanied by pain. Drainage from the wound is expected but should be watery or light pink. A dark, bloody, or smelly drainage from the wound is a sign of infection. Systemic reactions to infection affect the whole body and most commonly present as a fever. If these signs present, a return visit to the medical provider is necessary where further treatment can be provided.

Infected Knee Sutures

Rabies Concern

In addition to wound care and antibiotics, with animal bites there is a concern for rabies exposure. There are typically two scenarios that will determine if rabies treatment is or is not necessary.

Case 1: The Pet Dog

Christa was bitten by her family's pet dog. Christa's parents are able to confirm that Christa was bit while playing, perhaps a little too roughly, with their family pet, Rover. Rover is three years old, healthy, and had all his doggie-shots updated just last month at the vet.

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