Replantation dilemma: lessons learned from managing a dog bite forearm amputation in a sixteen-year-old girl.

R De Vitis, A Cannella, A Cruciani, L Caruso, G Bocchino, G Taccardo
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Abstract

Background: Bite injuries, particularly those involving the hands, present a significant medico-legal challenge, often leading to complications and frequent emergency department visits. Dog and cat bites, especially among children, are major contributors to infections due to the complex anatomy of the hand, which predisposes it to severe infections even from minor bites. Capnocytophaga canimorsus, found in the oral cavity of dogs and cats, is particularly concerning due to its potential to cause severe infections. Prompt and appropriate treatment is essential to mitigate these risks. Managing such injuries poses significant challenges, necessitating clear guidelines for reporting and safety measures. This article highlights the urgent need for additional research, support, and education, particularly focusing on children, along with the development of international guidelines to improve outcomes for patients.

Case report: A case study of a sixteen-year-old girl who had her left forearm amputated due to a rottweiler bite is presented. Despite initial attempts at replantation, complications led to the decision for amputation.

Conclusions: This case underscores the challenges in managing severe dog bite injuries, emphasizing the importance of prompt assessment, thorough debridement, and proper wound management to minimize complications. Additionally, psychological evaluation and treatment are crucial for patients and parents following such traumatic events. From a medical standpoint, this case highlights the importance of monitoring inflammatory markers, appropriate surgical priorities, and the need for psychological support. Prevention of dog bites is crucial, requiring increased awareness among public authorities and dog owners. Clear guidelines for reporting dog bites are essential, but further research is needed to improve their comprehensiveness and effectiveness.

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再植难题:从处理一名 16 岁女孩被狗咬伤的前臂截肢手术中汲取的经验教训。
背景:咬伤,尤其是涉及手部的咬伤,是一项重大的医学法律挑战,往往会导致并发症和频繁的急诊就诊。由于手部解剖结构复杂,即使是轻微的咬伤也容易造成严重感染,因此被狗和猫咬伤是造成感染的主要原因,尤其是在儿童中。在狗和猫的口腔中发现的嗜毛囊虫(Capnocytophaga canimorsus)尤其令人担忧,因为它有可能导致严重感染。及时和适当的治疗对于降低这些风险至关重要。处理此类伤害是一项重大挑战,需要明确的报告指南和安全措施。这篇文章强调,迫切需要开展更多的研究、支持和教育,特别是针对儿童,同时制定国际指南,以改善患者的治疗效果:本病例研究介绍了一名 16 岁女孩因被罗威纳犬咬伤而导致左前臂截肢的病例。尽管最初尝试了再植,但并发症导致了截肢的决定:本病例凸显了处理严重狗咬伤所面临的挑战,强调了及时评估、彻底清创和妥善处理伤口以减少并发症的重要性。此外,在发生此类创伤事件后,心理评估和治疗对患者和家长至关重要。从医学角度来看,本病例强调了监测炎症指标的重要性、适当的手术优先顺序以及心理支持的必要性。预防被狗咬伤至关重要,需要提高公共机构和狗主人的意识。明确的狗咬伤报告指南至关重要,但还需要进一步研究,以提高其全面性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
6.10%
发文量
906
审稿时长
2-4 weeks
期刊介绍: European Review for Medical and Pharmacological Sciences, a fortnightly journal, acts as an information exchange tool on several aspects of medical and pharmacological sciences. It publishes reviews, original articles, and results from original research. The purposes of the Journal are to encourage interdisciplinary discussions and to contribute to the advancement of medicine. European Review for Medical and Pharmacological Sciences includes: -Editorials- Reviews- Original articles- Trials- Brief communications- Case reports (only if of particular interest and accompanied by a short review)
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