Human or Animal Bites

Bites on the hand are common injuries that can result in a great deal of pain and lead to further problems, such as infection. The key to minimizing complications related to a bite is to be aware of early symptoms and seek treatment when needed.

When bitten, bacteria from the biter's mouth may enter the wound and contaminate it. If left unchecked, the bacteria can grow inside the  wound and cause a serious infection. This infection may only be mildly  annoying, but in some cases may even be life-threatening.

The likelihood and severity of the infection can depend on many things. The location and intensity of the bite, along with the health of  the person who was bitten, are all important factors. If, for example, the person who is bitten has a suppressed immune system, he or she may  be more vulnerable to infection. Additionally, the length of time between the bite and its treatment, the health of the animal or person who caused the bite, and any other foreign substances or bodies in the wound may increase the possibility or nature of an infection.

As many as three million animal bites occur in the United States each year, with dogs causing 90% of them. 5% are caused by cats, and the rest are mostly caused by rodents.

Most animal bites happen to children between five and fourteen years of age. Furthermore, in comparison to women, men are more often bitten by dogs. Women, conversely, are more likely to be bitten by cats. Cat bites result in a greater number of infections because their teeth are  sharper and puncture more deeply.

Unfortunately, the skin of the person bitten usually covers and seals  the site of the bite, thus preventing the wound to drain. The damage caused by the bite itself, therefore, is often less of a worry than the infection that can result. While 1% of dog bites and 6% of cat bites require hospitalization, prompt attention and care usually means the  chances for recovery are very good.

The chance of infection is very high in cases involving a human bit. Human mouths actually have high concentrations of bacteria. Since the  infection can grow quickly and lead to serious complications, early  treatment is critical. Human bites most often result from a punch to the  mouth. If left untreated, an infection can grow deep in the knuckle joint and, eventually, destroy it. If treated, however, the response to  an early diagnosis, intravenous antibiotics, and surgery performed by a hand surgeon is usually rather positive. 

Emergency treatment, in either your doctor's office or any emergency health care facility, should be sought if any of the following are  present:

• Swelling, redness, or warmth around bite area after 24 hours
• The wound is draining or leaking pus
• Red streaks run up the arm or forearm
• Lymph nodes (or "glands") around elbow or in the armpit become swollen
• There is a loss of mobility in the arm, hand, or wrist that was bit
• There is a loss of feeling in the hand or fingertip
• The person bit begins feeling fever, malaise, night sweats, or rigors

To properly treat the bite, your hand surgeon will begin by examining  the wound. He or she will also ask a few questions about how the injury was sustained. You should be prepared to provide a detailed report about the bite to your hand surgeon, including the type of animal that  caused it and its general health. Anything known about the vaccination history of the animal or its behavior may be important.

If you haven't had a tetanus booster within the past ten years, your doctor may recommend that you get one.

To see if there was any damage to the bone or joint, or if foreign pieces are embedded in your hand (e.g., pieces of a tooth), an x-ray may be taken. If the bite caused an infection, it may have spread to the surrounding bone forming a condition called osteomyelitis, which can also be revealed by an x-ray.

Any animal bite to the hand or fingers needs to be thoroughly and completely cleaned. The hand doctor or other medical provider will first wash the area and may have to trim away any dead tissue, skin, blood clots, or foreign matter that could lead to infection. Your doctor, and  you, should be alert for any red streaks on the forearm, a sign of lymphangitis, and for any sign of swelling on the inside of the elbow, which can indicate a swollen lymph node. If the wound is thought to be infected, a culture will be taken to see what type of bacteria is causing it and what antibiotic should be taken to combat it.

To make sure that the infection was properly treated, follow-up care including visits to your hand surgeon is critical.