I received an email via our iPhone App from a mom who was very worried after her daughter had been bitten by a friend's dog.  This is a common concern/query to the pediatrician.  In fact, one of my own children was severely bitten by a friend's dog, but I had somehow forgotten that experience and the 20 stitches to his face!

Tincture of time is the best remedy for many things. At any rate, I looked at the CDC's website to find that there are over 5 million dog bites a year and about 800,000 require medical attention. No wonder the health care system is overflowing!

This mother was concerned as to what was the appropriate treatment. Her daughter's bite was on the face (very common for a child) but small. It did break the skin. The first thing a parent should do is to stop the bleeding by applying pressure. Then, clean the area with warm water and soap. Dogs, like humans, have dirty mouths, so you want to wash and rinse well and even flush out the wound if it is deep.

If the bite wound is small, it is usually not sutured, as this may increase the risk for infection. On the other hand, facial wounds, and larger bites have to be well cleansed and irrigated, and may require suturing. The sooner this can be accomplished the better. For a child with a dog bite that has broken the skin, most pediatricians would recommend a 7-day course of an antibiotic, typically Augmentin (unless the child is penicillin allergic).

Rabies is usually not a risk in dogs that are family pets and in homes. If the dog is not known or their rabies status is unclear and you cannot find the dog, check with your pediatrician about rabies prophylaxis.

Lastly, you want to ensure minimal scarring by using a topical vitamin E cream on the healed skin and sunscreen. The less the sun exposure, the less scarring, especially if the face is involved.  That really goes for all cuts and scars.

That's your daily dose, we'll chat again tomorrow.

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