Human bite injuries and the associated complications are not uncommon in the West African sub-region. The injuries are commonly documented by researchers in the industrialized countries where forensic studies are routinely used to identify the culprits for possible legal prosecution. These forensic investigations include dental casts, DNA analysis of skin prised from the nail beds of the victim, blood and body fluid2,3,4.
The paper in this issue from north-central Nigeria shows an emerging pattern - human bite injuries involved more frequently the upper limbs, young male adults, low socio-economic class, occurring more commonly in assaults and domestic conflicts, with high morbidity because of the site of the injuries and late presentation1.
The incidence of human bite injuries have been shown to be under reported as the victims may not wish to expose the circumstances that led to the bite especially when they occur between spouses and when there could be legal repercussions.
The challenges in managing human bite injuries include the wound care, prevention of infections including tetanus, maintenance of cosmesis where disfigurement occurs, treatment of the associated injuries and prevention of the circumstances that led to the bite5. Though primary closure of the wound is recommended in bites of the face, delayed primary closure and secondary closure may be better options in other areas of the body especially when the wound is infected6,7.
The complications associated with human bite injuries include infections which include tetanus and HIV8, disfigurement especially if the injuries involve avulsion of structures of the face and when the male genitalia are involved. The buccal cavity contains both aerobic and anaerobic organisms and in some cases HIV and hepatitis viruses. The associated injuries sustained during the assault in patients with human bites could be more serious than the bite injuries1.
The need to identify objectively both the biter and the victim in legal proceedings raises the need to establish DNA analysis facilities which could identify the biter from swabs of the bite marks, body fluids, blood and skin prised from the nail beds of the victim. This area of forensic pathology is still deficient in most centres in the West African sub-region.
References
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