Abstract:

Objective: To compare the therapeutic effects between primary closue and delayed closure in the patients with dog bite wound,and to discuss the feasibility of primary closure.Methods: A total of 31 patients with dog bite wound were included. The patients were divided into primary closure group(n=20) and delayed closure group (n=11) according to the closue methods. The patients in primary closure group were given the routine soapy water to wash the wound, skin disinfection, local anesthesia, debridement, gentamicin and metronidazole douche, flap transfer and wound closue, antibiotics after the operation, and vaccination of rabies vaccine and tetanus vaccine. The patients in delayed closue group were given the conventional soapy water to wash the wound, skin disinfection, local anesthesia, debridement, gentamicin and metronidazole douche, sterile gauze to cover the wound, regular dressing replacement, delayed closure of wound,routine injection of rabies vaccine and tetanus vaccine after the operation,and systemic antibiotics. The infection rate of wound and Vancouver Scar Rating Scale (VSS) scores of the patients in two groups were compared.Results: Among 20 patients in primary closure group,there were 2 patients (10.00%) showed different degrees of wound infection,and there was no systemic infection, rabies and tetanus; among 11 patients in delayed closure group,there were 2 cases (9.09%) showed different degrees of wound infection,and there was no systemic infection, rabies and tetanus. There were no significant differences in the infection rates of wound of the patients between two groups (P>0.05). The VSS score of the patients in primary closure group (Z=257) was higher than that in delayed closure group (Z=239), and the difference was statistically significant (P<0.05).Conclusion: The infection rates of wound of the patients in primary closure group and delayed closure group are basically the same. However, the wound treated with the primary closure shows cosmetic appearance compared with delayed closure. Therefore,primary closure may be an acceptable therapeutic method for the patients with dog bite wound.

Key words: dog bite, primary closure, delayed closure