• H E de Melker and R A de Melker.
• Rijksinstituut voor Volksgezondheid en Milieuhygiëne, Centrum voor Infectieziekten Epidemilogie, Bilthoven.
• Ned Tijdschr Geneeskd. 1996 Mar 30;140(13):709-13.

ObjectiveTo determine, on the basis of published research on dog bites, risk groups and localisations, risk factors for wound infection, effectiveness of prophylactic antibiotics and indications and contraindications for primary closure of the bite wounds.DesignLiterature study.MethodsSearch in Medline (1975-October 1994) on "dog" and "bite(s)" and selection using methodological inclusion and exclusion criteria.ResultsIncidence of dog bites is highest in younger children and in hands/arms. The infection rate amounts to 3-17%. Risk factors for wound infection include hand/arms, puncture wounds, delay of presentation and possibly older age. The effectiveness of prophylactic antibiotics appears to be limited. There is no evidence that the infection rate after primary closure of wounds is higher. Cleaning and debridement are important.ConclusionsMore attention should be paid to prevention of dog bites, especially in children. Most important is adequate cleaning of the wounds. Antibiotics should be given on indication only, such as hand wounds, puncture deep wounds and immune compromised patients. Primary closure is not contraindicated.

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