Congeneric bites, a challenge in daily clinical practice. Case presentation and minireview

Abstract

Bite wounds can range from simple local injuries to involvement of the musculature, blood vessels, organs and bones, often leading to complex treatments including surgery and hospitalization. These wounds present a phenomenon known as the "iceberg" effect, which can hide the true severity of the injury and require more invasive management to prevent complications, although these are frequent. Comprehensive management of the patient is fundamental for an adequate resolution of the pathology and depends on several factors, such as the time in which the wounds are approached (known as the "golden period"), which is crucial to prevent contaminated wounds from becoming colonized or infected wounds. In addition, the patient's general health and nutritional status, among other aspects, also play a role. Complications following mammalian bites are frequent and constitute one of the most common consultations in emergency departments. In this work, we describe the evolution of a case of generalized systemic infection due to a domestic dog bite, which was successfully treated and discharged in 28 days. Proper preparation of the wound using various methods, dressings and constant instillation systems of antiseptic solutions that favor healing in an optimal environment, as well as the application of V.A.C. negative pressure therapy, allowed the case to be resolved in 28 days. This demonstrates that a correct classification, an adequate approach and knowledge of current strategies in advanced wound management shorten recovery times, improve the patient's quality of life by avoiding daily manipulations, and result in an acceptable cost/benefit for the pet owner