동물교상과 예방백신

Abstract

Animal bites are a common problem managed by primary physicians and often involve wound infection, neurovascular injury, poor cosmetic outcome, and high medical costs. During clinical assessment, a thorough medical history is acquired, including details of the bite circumstances and the patient's immune status and vaccination history. A meticulous physical examination should be performed in order to identify any injuries to deep structures, in addition to exploring the wound by creating a narrow opening and using diagnostic tools such as radiograph and ultrasound where necessary. Infection is the most problematic complication after a bite injury. Cleaning, irrigation, and debridement are the most important steps in preventing infection. The use of prophylactic antibiotics is controversial, but probably indicated in immunocompromised individuals and in anatomical areas that are more likely to be infected, such as the hand and foot. The decision to close a bite wound must be based on consideration of the benefit of a good cosmetic outcome and the increased risk of infection. In Korea, human rabies has not occurred since 2005, but the transmission of rabies is still a concern with animal bites. The transmission of viral hepatitis, herpes virus and human immunodeficiency virus can occur following human bites. To prevent the transmission of various viruses, healthcare providers should know the guidelines for post-bite exposure prophylaxis.