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Tuesday, February 5, 2019

New Protocols for Dog-Bite Treatments Receive National Recognition

Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth) and the only all-specialty pediatric facility in the Hudson Valley, has devised new guidelines to treat dog bites. The regimens result from a research study named “best published paper” in North America in 2018 by Plastic and Reconstructive Surgery – Global Open, a rigorously peer-reviewed international journal focusing on global plastic and reconstructive surgery.

The study was conducted by Kaveh Alizadeh, MD, MSC, FACS, Chief of Plastic and Reconstructive Surgery at Westchester Medical Center, flagship of WMCHealth. It was published by the American College of Plastic Surgeons, which educates and supports efforts by plastic surgeons around the world to provide the highest quality patient care while maintaining professional and ethical standards through education, research and advocacy.

“This is a game-changing paper,” said Dr. Alizadeh. “When you have a child bitten by a big dog, you have to treat differently. The injuries can be devastating.”

The study reports that 4.5 million dog bites occur in the United States each year, and that hospitalizations have increased 86 percent in the last 20 years. Data from January 2012 to December 2014, encompassing 108 cases at Maria Fareri Children’s Hospital, were analyzed to identify patterns in locations of wounds, dog breeds and treatments.

Dr. Alizadeh commenced the study after noting a large number of referrals of patients with dog bites to Maria Fareri Children’s Hospital. The research findings, he said, have been highly referenced in the medical community, making these therapies the new standard of care.

The analysis found:

  • When dog breeds could be identified, most bites (48.2 percent) were from pit bulls, typically large, energetic dogs. Nearly 48 percent of those cases – three times more than other breeds – required surgical repair.
  • Up to 50 percent of the bites were from household pet dogs.
  • Nearly 60 percent of the bites were in the head and neck because children’s growth is progressing and these sensitive areas are closer to the ground where dogs can reach them.
  • Children ages 9 to 12 years old were most frequently attacked, and hospitalizations are typically much longer.

Treatment regimens identified include:

  • Simple puncture wounds and abrasions: Irrigating the wound and applying dressing. Patients visit a pediatrician or a surgical specialist in three to five days.
  • Simple or certain complex lacerations: Repaired in the Emergency Department, with medicine to manage pain provided. The patient follows up with a physician visit within a week.
  • Complex lacerations: Dead tissue is removed. If the patient cannot tolerate local sedation, hospital admission and surgery are required.
  • Complete tissue-loss injuries: Wounds are cleaned and bone fractures addressed.

For appointments with, or referrals to, Dr. Alizadeh and the Division of Plastic Surgery team, please call 914.909.6880.

To learn more about Dr. Alizadeh please CLICK HERE.

CLICK HERE to read “An Algorithmic Approach to Operative Management of Complex Pediatric Dog Bites: 3-Year Review of a Level I Regional Referral Pediatric Trauma Hospital."