Pediatric dog-bite injuries of the ocular adnexa

Abstract

Background: Although domestic dogs have been human companions for thousands of years, their uncontrolled aggressive behavior may cause a canine attack on a human, leading to severe injuries. As much as 1.5% of the population receives a dog bite requiring medical attention annually and dog bite prevalence is twice as high among children when compared to the population of other age groups. Purpose: To review the clinical features of and outcomes of surgical treatment for pediatric dog-bite injuries to the ocular adnexa. Material and Methods: We retrospectively reviewed the clinical features of and outcomes of surgical treatment for pediatric dog-bite injuries to the ocular adnexa in 25 children aged 2-13 years (mean age, 5.5 ± 3.1 years). Results: Bites affecting the lower eyelid were most common (68%). An injury to the lacrimal duct in the form of canalicular avulsion was seen in 52% of all cases and 76.9% of children with a lower eyelid injury. All children received urgent primary surgical wound repair (PSWR) with suture wound closure. When a laceration of the inferior canaliculus occurred, canaluculus repair and intubation was performed using different methods. Conclusion: During PSWR, necrosed tissue should be removed with preservation of vital tissue as much as possible, because adequate vascularization and young age contribute to active tissue reparation. Restoration of the integrity of and passage through the lacrimal duct are essential to prevent postoperative epiphora.

Keywords

• bite injury
• ocular adnexa