International Surgery Journal | September 2018 | Vol 5 | Issue 9 Page 3017 International Surgery Journal Jain RK et al. Int Surg J. 2018 Sep;5(9):3017-3022 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Diverse spectrum of facial dog bite presentation and their management Rakesh Kumar Jain, Gautam Prakash*, Manojit Midya, Pankaj Sharma INTRODUCTION A substantial association has been seen between dogs and humans. 1 Dog bite patients are frequently encountered in our hospital seeking immediate as well as delayed reconstruction. More than two third of dog bite injuries involve head, neck and scalp region. 2,3 Most of the dog bite injuries are deep seated, as skin flaps may appear viable but underlying tissue is devitalized requiring proper assessment (Table 1). 4 Facial dog bites present a challenge for the surgeon, as they lead to cosmetic disfigurement and psychological trauma to the patient. Although dog bites have been reported on almost all areas of the body, but there is predilection for head, neck and scalp in pediatric age group and for upper limbs in adults. 5 Young children are more prone for head and neck involvement due to relatively large head size, short stature and less fear of mishap. Also, young children are physically less able to defend themselves and escape. 6 ABSTRACT Background: Dog bite patients are frequently encountered in our hospital seeking immediate as well as delayed reconstruction. More than two third of dog bite injuries involve head, neck and scalp region. Facial dog bites present a challenge for the surgeon, as they lead to cosmetic disfigurement and psychological trauma to the patient. Following thorough washout and debridement, we have used various reconstructive techniques for definitive management of wounds like- primary repair, V-Y advancement flap, nasolabial flap, SSG, FTG and Karapandzic flap. Purpose of the present study is to share our experiences in management of dog bite wounds on the face in both adult and paediatric patients with available reconstructive options to maximize the functional and cosmetic outcomes by using basic principles of surgery. Methods: Present study was a single centre retrospective study conducted in a tertiary care centre from February 2013 to January 2018. Total 497 patients of dog bite who presented in the emergency department were enrolled. Out of them 310 patients had involvement of head, neck and scalp requiring surgical intervention in any form. Results: In last five years, we have encountered mid face predilection in face, head and neck cases. Out of 310 cases, lip (25.16%) and cheek (24.51%) were involved in majority of the patients. Flap cover surgery is required in majority of the scalp and nose group of patients, as there is less mobility of tissue present in surrounding region, while cheek and lip were managed with primary closure in most of the patients. Conclusions: Although most of the dog bites are preventable, but cases of dog bite are increasing continuously. Child should never be left alone with dogs and, if they are fear of dogs, it’s better not to obtain dogs. As far now, it’s a major concern for treating physician or surgeon to provide optimal cosmetic as well as functional outcome. Early surgical intervention for wound management gives better results with the use of basic principles of plastic surgery. Keywords: Dog bite, Dog bite management, Facial injury Department of Plastic Surgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India Received: 03 August 2018 Accepted: 10 August 2018 *Correspondence: Dr. Gautam Prakash, E-mail: drgprakash86@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20183452