Life-threatening dog attacks: A devastating combination of penetrating andblunt injuries

Background/Purpose: Children often are the victims of dog attacks. Although bite injuries sustained in an attack characteristically are attributed to the penetrating component of the bite, the blunt nature of a bite may repre sent the most serious and devastating component of injury. The purpose of t his study was to characterize a group of children suffering life-threatenin g dog bites and examine the predominant aspect of injury. Methods: Thirty-nine children were admitted to the trauma service at a regi onal pediatric trauma center with the diagnosis of dog bite injury over a 6 -year period (1994 through 1999). Patient demographics, site and descriptio n of injury, and surgical procedures performed were recorded from a chart r eview. Results: Mean age of the 35 children included for analysis was 5.4 years (r ange, 0.8 to 17 years). Twenty-five (71%) injuries occurred in the head and neck region. Eight (23%) children sustained life-threatening injuries. Of these, blunt force was the predominant injury in 6. This resulted in 1 (20% ) arterial occlusion requiring vascular reconstruction, 2 (40%) permanent n eurologic injuries (stroke, spinal cord transection), and 1 (20%) death (ex sanguination). Conclusions: On evaluation of a dog attack, the focus generally is on the o bvious penetrating aspect of the bite. Yet, we found the blunt component of injury can have devastating consequences reflected in acute arterial, brai n, and spinal cord injury. Even in the absence of significant penetrating t rauma, further evaluation should be considered to exclude occult blunt arte rial or neurologic injury. J Pediatr Surg 36:1115-1117. Copyright (C) 2001 by W.B. Saunders Company.