One day after school, my then seven year old son came to me crying, holding his wrist and moaning that Thomas had just bit him. I quickly looked at my son’s hand and gasped at the sight of the small round tooth punctures between his forefinger and thumb. Panicked, I said to another mother, “OMG, human bites are the worst!” and I immediately got my son in the car and drove him to the local urgent care center.
Approximately one third of all hand infections are caused from a human bite. Human bites in the hand have a much higher incidence of infection than bites to other parts of the body. The wound can look minimal but the infection can spread deep into tendons and surrounding tissue. A human bite that breaks the skin should be seen by a doctor for treatment preferably within the first 24 hours. All bites that occur to children should be evaluated even without a deep puncture.
Common types of human bites:
1. Closed fist: A punch to the mouth results in an indirect puncture of a tooth to the knuckle joints;
2. Chomping: A person bites down on another person, common among children; and
3. Avulsion: The bite tears the skin creating a flap. This occurs more often on the face, ear or neck.
The human mouth is full of bacteria and the bite pushes the bacteria into the puncture wound. Elsewhere in the body, human bites and animal bites have about the same rate of infection but in the hand, the human bite infection rate is much higher.
What to do:
In general, plan on observing the area for signs of infection: redness, heat, swelling and cloudy drainage. Make sure to see a doctor within 24 hours for a deeper puncture bite so that antibiotics can be started to prevent infection. A tetanus shot may also be given if needed.
If the skin is only superficially broken: Wash and dry the bite with soap and water. Use a topical antibiotic ointment to prevent infection. Do not put the bite area in your mouth which only exposes it to more bacteria. Keep an eye on the area over the next few days to make sure no tendons or nerves were damaged. Look for signs of numbness or difficulty moving the fingers.