When Man Bites Man

Treating people who are bitten by animals poses little problem for doctors, but what do they do when the biter is another human?
That’s the question researchers set out to answer in a new study published in this month’s Otolaryngology -- Head and Neck Surgery. Their review of 10 years worth of hospital records in Galveston, Texas, identified several key areas they believe can form a standard protocol to follow when man bites man.
The study uncovered 40 human bites between 1990 and 2000. The average victim was a young adult male. About two-thirds received their bites while incarcerated in a local prison and most occurred during an altercation. The most common site of the bite was the ear, and more than two-thirds of the patients presented with exposed cartilage. Patients received tetanus shots when needed, along with other standard medical care. On average, patients were followed for around four months.

Researchers were especially interested in finding out what role infection plays in human bites and how surgical intervention might influence the development of infection. Results showed six of the wounds that were closed soon after the incident became infected, compared to none of the wounds closed more than 24 hours after the bite. Post-operative infection was also associated with exposed cartilage and receiving less than 48 hours of IV antibiotics.

The investigators conclude human bites are best treated with at least 48 hours of IV antibiotics and delayed surgical closure. Noting human bites make up between 2 percent and 23 percent of all bite wounds, and about half of all people in the United States will experience a human bite at some time in their lives, researchers believe these guidelines can go a long way to improving care for patients. They say, "The timing of treatment and medical and surgical management of human bite injury significantly impacts wound infection."