Table 2.
Factor | High risk | Low risk |
---|---|---|
Species | Domestic cat Large cat (deep punctures can penetrate joints, cranium), Human (in hand wounds only), Primate(anecdotal evidence only), Pig, monkey |
Dog Rodent |
Location of wound | Hand, feet, wrist Scalp or face in infants (high risk of cranial perforation) Below knee Through-and-through oral Penetration of underlying tissue (bone, joint, tendon, vascular) |
Face, scalp, ear and lip |
Wound type | Puncture (impossible to irrigate) 40 % of all bite infections) Extensive crush that cannot be debrided (typical of herbivores such as cows, horses) Contaminated Delayed presentation >12 h |
Superficial, large clean lacerations that can be thoroughly cleansed; the larger the laceration and the better the cleansing, the lower the infection rate Clean Recent |
Patient | Elderly Diabetic Peripheral vascular insufficiency Asplenic Chronic alcoholic Chronic corticosteroid therapy Cytotoxic drugs Altered immune status Prosthetic or diseased cardiac valve (consider systemic prophylaxis) Prosthetic or seriously diseased joint (consider systemic prophylaxis) |