Don't Shake Off Hand Bites From Pets, People
Perhaps you are familiar with the idiom, “don’t bite the hand that feeds you.” This popular saying is a lighthearted way to highlight a serious fact: approximately 330,000 cases of hand bites are seen in emergency departments each year in the United States, and these injuries have the potential to be serious.
Hand bites have a higher infection rate than do similar wounds on other sites of the body, whether the bite is from a human or animal. One reason is that people are hesitant to see a doctor or to take care of a hand bite immediately, and another is that the skin on the hand is very thin.
In a new review appearing in the Journal of the American Academy of Orthopaedic Surgeons, the authors emphasize how important it is to promptly treat a hand bite to reduce the risk of infection and disability, including amputation. If you or a loved one receives a bite to the hand, be sure to heed their advice.
About hand bites
More than 90 percent of bites come from our feline and canine companions. Depending on the size of the dog, a bite to the hand can cause serious damage to the tendons, ligaments, and even the bones. Cat bites may lack the force of a big dog attack, but their sharp, narrow teeth can cause considerable damage as well.
In fact, between 30 and 50 percent of cat bites develop infections. These infections could be prevented or limited if people acted promptly, because about half of the infections occur as quickly as within three hours of the bite.
In a study from Mayo Clinic in February 2014, researchers reported that nearly one third of individuals who had sought treatment at the clinic for a cat bite to the hand over a three-year period had required hospitalization. The reason, they noted, was that such bites usually were located over a tendon or joint and were associated with pain, redness, and swelling.
What’s so special about these locations? Regardless of whether the bite is from a cat, dog, or human, the joints and tendons have closed spaces, and these spaces are incubators for bacteria. One big challenge is that antibiotics tend not to reach these spaces, which means doctors must go in surgically and remove the infection if one develops.
The bacterial species most often associated with dog and cat bite wounds are Pasturella sp, while Eikenella is typically seen in human bites. Others that are common to all mammals include Staphylococcus, Streptococcus, and anaerobic bacteria species.
Only two to three percent of hand bites are human in nature, but they can be serious as well. Human bites typically occur during fist fights, when children bite, as the result of domestic abuse, or during sporting activities.
The most common type of hand bite injury is a clenched-fist injury, which occurs when a closed fist makes contact with someone’s teeth. A more direct bite is the second most common type of hand bite.
Human saliva can deliver more than 600 different bacteria species and carries a high risk of infection. Human bites have been associated with the transmission of hepatitis B, hepatitis C, herpes simplex virus, syphilis, actinomycosis, tetanus, and tuberculosis.
What should be done with a hand bite
- Wash the hand immediately with soap and warm water, even if you don’t see any obvious punctures or breaks. Even minute breaks in the skin can allow in bacteria
- Seek medical care. It is preferable to see a professional within 24 hours of the bite to prevent serious infection or disability. However, as noted, cat bites can become infected sooner.
- If you experience a fever and/or feel an increasing amount of pain, swelling, and/or observe redness or red lines extending from your hand, get immediate medical help, as these are indications of a serious infection
- Doctors typically give antibiotics for hand bites because they can reduce the risk of infection from an average of 28 percent to 2 percent, according to the reviewers
- Hand bites that are more serious (e.g., damage to the tendons, bone exposure) may require surgical irrigation, cleaning, and removal of unhealthy tissue
Babovic N et al. Cat bite infections of the hand: assessment of morbidity and predictors of severe infection. Journal of Hand Surgery 2014 Feb; 39(2): 286-90
Kennedy SA et al. Hand and other mammalian bite injuries of the hand: evaluation and management. Journal of the American Academy of Orthopaedic Surgeons 2015 Jan; 23(1): 47-57