Treatment and outcome of human bites in the head and neck

OBJECTIVE: Our goal was to review head and neck human bite injuries for demographic, treatment, and outcome data to identify factors influencing infection. STUDY DESIGN: Retrospective chart review of all human bite injuries (adult and pediatric) over 10 years. SETTING: Tertiary referral medical center. RESULTS: We reviewed 40 human bites (average follow-up, 139 days). Young males were the most common victims, altercation was the most common etiology, and auricular avulsion was the most common injury. Six wounds closed primarily became infected (40%) versus no wound infection with delayed closure. Primary wound closure (P < .01), exposed cartilage (P < .07), and less than 48 hours of intravenous antibiotics (P < .06) were associated with postoperative infection (P < .01). CONCLUSION: Human bites to the head and neck, especially those with exposed cartilage, are best treated with at least 48 hours of intravenous antibiotics and delayed surgical closure (>24 hours postinjury) to prevent infection. SIGNIFICANCE: This information enables the clinician who sees these bite wounds infrequently to understand the treatment associated with avoiding infection.