Human bites become more common

Press, 29 June 1987, Page 6

Human bites become more common

From

Dr George Honbury

for the Royal New Zealand College off General Practitioners.

Anyone who read Errol Flynn’s autobiography when it appeared 20 or so years ago will remember his account of the pain and swelling he suffered as a result of having been bitten on the hand by an assailant. Two writers from Birmingham reviewed the effects of human bites recently in an editorial in the “British Medical Journal.” Man, they say, does at times bite dog, but

increasingly man seems likely to bite man — in fact, in New York City, man-bites rank third in commonness behind dog and cat bites. About threequarters result from “aggressive behaviour,” they say, and the rest are “accidental.” Battered chil-

dren are often the victims, but others are those who care for psychiatrically disturbed people, and for dentists man bites are an occupational hazard. They may also occur in “sporting or sexual activity.”

The hands are the most common site, and here the straightforward bite must be separated fromthe more serious injury resulting from a clenched fist in the teeth of another. The teeth may penetrate tendon or joint and damage the smooth cartilage of the latter. With the fingers extended the wound may appear trivial, its true extent masked as the wound edges are held together. Delay at this stage may be disastrous for later hand function. Human bites have a great potential for infection, and the severity of the infection reflects the dental hygiene of the biter. Most common infectious bacteria can cause local infection. but

syphilis and hepatitis B have been spared in this way, and probably A.I.D.S. will be in the future, since the human immunodeficiency virus has been isolated from saliva.

The merely scratched or grazed hand can be treated locally, but the clenched fist injury always needs prompt attention. Delay in treatment of a deep man bite is

dangerous, and the writers suggest that treatment in hospital is usually needed: the wound should be properly explored, washed out, and the hand elevated. Serious infection may result even with proper, care, so antibiotic treatment is recommended from the outset. Complications may occur later. Septicaemia and death have been reported, though more often loss of function, joint stiffness, and inflammation of joints and tendons result. Man bites are serious injuries, and should be regarded as such. Early, prompt and thorough treatment may prevent long term disability.

Family Doctor