A Clinical Approach to Animal Bites with an Avulsion Flap: A Case Report.

INTRODUCTION: Animal bites are a common reason for visits to the Emergency Department in the US and worldwide. There are many different approaches to managing these wounds.

CASE PRESENTATION: We present a case of a 90-year-old white woman who sustained a large dog bite to her hand, over the dorsal aspect of the first metacarpal. We used the avulsion flap as a biologic dressing and employed a perforating technique to successfully treat the wound and allow for optimal wound healing.

DISCUSSION: Pitfalls to this dog bite management approach include the risk of infection and flap necrosis. Patients must obtain proper follow-up in 24 to 72 hours to reevaluate the wound. To optimize outcomes, comorbidities, location of the bite, complexity of the bite wound, and the risks of infection must be considered when one is choosing the best approach.