Men are 12 times more likely than women to sustain severe human bite injuries for which surgery may be necessary, according to a study published in the July issue of the Emergency Medicine Journal.

Injuries are most likely to occur during brawls at weekends or public holidays and in most cases alcohol is involved.

The researchers reviewed the 92 patients requiring assessment for human bite wounds by the plastic surgery service at St James's Hospital Dublin, Ireland, between January 2003 and December 2005. Eight five of them (92%) were men and the 92 patients had a total of 96 bites.

Alcohol was implicated in 86% of the injuries and illicit drugs in 12%. Seventy per cent of incidents resulting in a bite wound had occurred during the weekend or on a public holiday.

Seven out of ten bites were to the face and 65% of the facial injuries were to the ear.

Bites became infected in one in five patients and infection was most common when patients waited longer than 12 hours to seek medical attention.

Only 14% of the patients reviewed have or plan to undergo reconstructive surgery for the damaged caused by the bite.

Human bite wounds are a relatively common reason for referral for plastic surgery and there are two main types: the occlusive bite with or without tissue loss which occur when teeth close on the skin and have been seen in several high profile contact sporting events, including the Tyson-Holyfield boxing match in 1997; and the 'fight bite' when flesh on a closed fist is pierced by a tooth.

The authors say: 'The incidence of human bite wounds is largely unknown because many minor injuries do not present to the emergency department for medical assessment.

'The human bite injury is a deceptive wound and because of the potential for infective, functional and aesthetic complications it requires prompt treatment.'

The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon
Emergency Medicine Journal 2007;24:455-458. doi: 10.1136/emj.2006.045054
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