The spectrum of animal related injuries managed at a major trauma centre in South Africa.

Abstract

BACKGROUND:

Humans come into contact and interact with an array of animals in a number of areas and environments. We set out to review our experience with animal-related injuries in Pietermaritzburg, KwaZulu-Natal, South Africa.

METHOD:

All patients who sustained an injury secondary to an interaction with an animal in the period December 2012-December 2017 were identified from the Hybrid Electronic Medical Registry (HEMR).

RESULTS:

There were 104 patients in the study sample. The mean age of patients in the study was 32.8 years, with a range from 1 to 76 years old. 75% (n = 78) were male and 25% (n = 26) female. Out of the 104 animal-related injuries, 67 were blunt trauma, 39 penetrating trauma and 3 a combination of blunt and penetrating trauma. The species causing trauma included dogs (53), horses (29), cows (18), buffalo (1), warthog (1), impala (1) and a single goat (1). The median time from injury to hospitalisation was 46.62 hours (range from 0 to 504 hours). Injuries occurred to the head (n = 32), face (n = 9), neck (n = 32), abdomen (n = 22), urogenital system (n = 6), upper limb (n = 39) and lower limb (n = 39). The Injury Severity Score (ISS) mean for the patients was 8.16, the range 1-4, the median 9 and the standard deviation 6.88. In 49 patients the treatment was non-operative. In the remaining 55 patients, a total of 68 operative procedures were required. Operations included wound debridement/surgical washout (n = 38), laparotomy (n = 9), arterial repair/ligation (n = 8), skin graft (n = 4), craniotomy (n = 5), fasciotomy (n = 2), amputation (n = 1), and placement of an ICP monitor (n = 1). 49 of these operations were for patients with dog bite injuries. The mean hospital stay was 0.13 days with a range of 0-4 days. Four patients were admitted to the Intensive Care Unit (ICU) and two patients died.

CONCLUSION:

Human interactions with animals may result in injuries which require surgical treatment. The most common animal injury is a dog bite but in the case of the larger domestic farm animals, blunt force type injuries and goring can result in significant injuries which require complex surgical interventions.

• Authors: E U Wessels, V Y Kong, J Buitendag, S Moffatt, R Weale, A B Ras, M Ras, M T D Smith, G L Laing, J L Bruce, W Bekker, V Manchev, D L Clarke
• Journal: South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie (S Afr J Surg) Vol. 57 Issue 3 Pg. 54 (Sep 2019) ISSN: 2078-5151 [Electronic] South Africa
• PMID: 31392866 (Publication Type: Journal Article)
• Copyright: Copyright© Authors.

Topics

• Abdominal Injuries (epidemiology)
• Adolescent
• Adult
• Aged
• Animals
• Cattle
• Child
• Child, Preschool
• Craniocerebral Trauma (epidemiology, therapy)
• Dogs
• Female
• Horses
• Humans
• Infant
• Injury Severity Score
• Length of Stay
• Lower Extremity (injuries)
• Male
• Middle Aged
• Neck Injuries (epidemiology, therapy)
• Retrospective Studies
• South Africa (epidemiology)
• Time-to-Treatment
• Trauma Centers
• Upper Extremity (injuries)
• Urogenital System (injuries)
• Wounds and Injuries (epidemiology, surgery, therapy)
• Young Adult