shutterstock_138766103Bites to the hand end up in as many as 330,000 emergency department visits in the United States each year, but prompt treatment can prevent serious injury and/or infection, according to a literature review in the January issue of the Journal of the American Academy of Orthopaedic Surgeons.

Human bites to the hand—while accounting for only 2% to 3% of all hand bite injuries—can occur during altercations and include wounds caused by punching-type contact with the mouth or teeth, domestic abuse, or accidentally during sports, play, or other activities. Human bites to the fingers and hand that penetrate through the skin can transmit infection through oral flora, or saliva, which contains more than 600 bacterial species.

Bites to the hand prompt as many as 330,000 emergency department visits in the United States each year.

Animals also have saliva containing a broad range of bacteria. Adult dog jaws, especially among larger breeds, are capable of exerting a bite force of more than 300 pounds, and when combined with the variety and sharpness of their teeth, can cause significant injuries to hand and finger ligaments, tendons, and bones. Cats do not have the jaw strength of dogs; however, their sharp, narrow teeth also can cause serious injury. An estimated 30% to 50% of cat bites are complicated by infections, which can occur as early as 3 hours after injury in approximately 50% of the infection cases. The annual health care costs associated with cat and dog bites are estimated at more than $850 million.

Prompt treatment, ideally within 24 hours of an animal or human bite, can stave off lasting consequences, including infection. Symptoms of infection include erythema, edema, progressive pain, and fever. All patients with hand bites should receive antibiotic treatment, which can lower the infection rate from an average of 28% to 2%. Open wounds may need to be surgically irrigated and debrided, the study authors point out.