Primary Closure in Animal Bites to Hands: A 7-year Retrospective Cohort Study

Abstract Background: Animal bites, particularly those involving the hands, are common. However, the management of these injuries, especially through primary closure, remains controversial due to the associated risk of infection. This study investigates the safety of primary closure with passive drains in hand wounds caused by animal bites. Methods: A retrospective observational cohort study was conducted at a rural hospital in Western Australia, reviewing 68 cases of hand wounds from animal bites between 2017 and 2024. Data collected included patient demographics, wound characteristics, treatment details, and outcomes. Statistical analyses were performed to compare infection rates across different closure methods. Results: Of the 68 cases, 48 involved dog bites, 12 cat bites, and 8 bites from other animals. Cat bites were significantly more likely to be infected at the time of surgery (75%) compared to dog bites (22.9%). The overall postoperative infection rate was 5.88%, while primary closure with a passive drain resulted in an infection rate of 4.17%. Conclusion: Primary closure of animal bite wounds to the hand, when combined with a passive drain, appears to be safe, with infection rates comparable to those of typical laceration repairs. This approach may offer a viable alternative to traditional management strategies, potentially improving patient outcomes. However, further prospective studies are necessary to confirm these findings.