Is immediate wound coverage possible in bite-related digital amputations?: a retrospective cohort study

Purpose: Bite wounds carry a high risk of infection, and the roles of antibiotics and the timing of wound closure remain a matter of debate. Limited evidence is available regarding bite-related finger amputations, particularly with respect to replantation and immediate wound coverage.Methods: We retrospectively reviewed 58 patients who underwent surgical treatment for bite-related finger amputations at our institute between 2009 and 2024. Demographics, injury mechanism, amputation level, and complications were analyzed. Major infection was defined as cases requiring operative irrigation and debridement. The infection rate observed in our cohort was compared with infection rates previously reported in the literature for primary closure of bite wounds.Results: Among 58 patients, 27 (46.6%) received immediate wound coverage and 31 (53.4%) underwent delayed coverage. No major infections occurred in either group. Replantation was attempted in 10 cases, with an 80% success rate; all failures resulted from arterial insufficiency rather than infection. Minor infections responsive to antibiotics were identified but did not require additional surgical intervention.Conclusion: Immediate wound coverage, including replantation when indicated, was not associated with an increased risk of major infection in bite-related finger amputations. These findings support the safety of immediate coverage and replantation and offer evidence-based guidance for surgical decision-making in hand trauma.