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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.
If the skin is more deeply punctured and actively bleeding: Do not try to clean it. Cover the bite area with a clean dry cloth such as paper toweling and let a doctor examine it. The doctor may decide to flush the area with saline if the puncture is deep or the skin is torn creating a flap. A bite puncture wound will not be sutured closed to allow for any drainage to drain from the puncture.
Follow-up:
The doctor may want you to return in a few days to check the bite area and see that it is healing well. According to the New York Dept. of Health, HIV is not commonly spread from saliva contact from a bite. The “biter” would also need to have blood in their mouth to transmit the virus. However, it is possible to get other salvia transmitted infections such as Hepatitis B, so follow up blood work may be needed.
In terms of children biting other children, they often do so out of frustration and outgrow the behavior. After my son’s experience though, I kept a closer eye on him at the playground.
Sources:
http://orthoinfo.aaos.org/topic.cfm?topic=A00003
www.healthline.com/galecontent/human-bite-infections
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles
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