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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Minor bites: A bite that just causes bruising or only scrapes the top layer of skin will not require much more than cleaning with soap and water, ice, and mild pain medication such as acetaminophen (Tylenol). A tetanus shot may be needed if the skin is broken and the patient has not had a booster tetanus in the last five years. Antibiotics are usually not necessary for this type of bite.

Deeper bites or bites causing cuts: Besides giving a tetanus shot when appropriate, the doctor will generally numb these bites with medicine (such as lidocaine) and then thoroughly clean and examine the wound. Cleaning of the wound, unless it is a puncture wound or very small, will usually involve squirting a large amount of clean water into the wound. With an open wound, sometimes large amounts of water directly from the tap are used to flush it out. Occasionally, a small amount of an antiseptic solution is added to the water before rinsing the wound, or skin around the wound. In the cleaning process, the doctor may cut out small pieces of tissue that appear to be dead. This helps decrease the risk of infection.

Stitches (sutures): The decision to use or not use stitches in a human bite depends on many factors. Doctors tend to use stitches less often in cuts caused by human bites because of the high risk of infection, especially from mouth to bacteria that may thrive in injured or dying or dead tissue (devitalized tissues). On the other hand, certain bites, especially those of the face, may turn out better if stitches are used, and the risk of infection in this area is not that high. Some stitches may only "loosely" close the wound to help the bite wound drain, but not provide an environment for growth areas for mouth bacteria.

• A very deep cut in the tongue, for example, will usually be stitched even though it is a human bite because doctors know that it will usually not get infected even if stitched.
• Most small cuts heal on their own even if stitches are not used. Sometimes the doctor will have the patient return in 4-5 days to see if stitches can then be used to close a large cut caused by a bite. This is called delayed closure.

Other treatment: The doctor may apply a splint to the bite area to keep it from moving. A sling may be used to help keep an injured hand elevated. Pain medication may be prescribed.

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