ABSTRACT Introduction: The epidemiological characteristics of accidents by canine and feline bites have been little studied in Peru. Objective: Determine the frequency and risk factors associated with canine and feline bites in Lima Metropolitana, during 2016. Methods: Descriptive cross-sectional study at the Zoonosis Control Health Center, in Lima, Peru. The sample consisted of 2175 attention sheets of canine and feline bites. The variables evaluated were: patient (age, sex, type of accident), characteristic of the bites (type of injury and anatomical area), and characteristic of the attacker animal (species, condition and habits). The frequency and odds ratio (OR) for each of the influential risk factors were calculated with their 95% confidence intervals. Results: The frequency of canine bites was 93.79% (men 61.20 %). 59.30% of cats attacked women. 58.23% of dog bites were located in the lower limbs (OR 8.02; IC: 4.95-12.29). 83.70% of cats attacked in the upper limbs (OR 14.19; IC:8.90-22.65). Canines and felines most often caused unique and superficial lesions. Conclusions: Bite-related risk factors vary by attacker species. Due to the persistence of cases, prevention programmes should be focused on population education, with an emphasis on the most vulnerable groups.

RESUMEN Introducción: Las características epidemiológicas de los accidentes por mordeduras caninas y felinas han sido poco estudiados en el Perú. Objetivo: Determinar la frecuencia y los factores de riesgo asociados con las mordeduras caninas y felinas en Lima Metropolitana, durante el año 2016. Métodos: Estudio descriptivo de corte transversal en el Centro de Salud Control de Zoonosis, Lima-Perú. La muestra estuvo conformada por 2175 fichas de atenciones por mordeduras caninas y felinas. Las variables evaluadas fueron: paciente (edad, sexo, tipo de accidente), característica de las mordeduras (tipo de lesión y área anatómica, característica del animal agresor (especie, condición y hábito). Se calculó la frecuencia y el odds ratio (OR) para cada uno de los factores de riesgo influyentes con sus intervalos de confianza al 95 %. Resultados: La frecuencia de mordeduras caninas fue del 93,79 % (hombres 61,20 %). El 59,30 % de los gatos atacaron a mujeres. El 58,23 % de las mordeduras de perros estuvieron localizadas en el miembro inferior (OR 8,02; IC: 4,95-12,29). El 83,70 % de los gatos atacó en el miembro superior (OR 14,19; IC: 8,90-22,65). Los caninos y felinos causaron con mayor frecuencia lesiones únicas y superficiales. Conclusiones: Los factores de riesgos relacionados con las mordeduras varían según la especie agresora. Debido a la persistencia de casos, los programas de prevención deben estar enfocados en la educación de la población, con énfasis en los grupos más vulnerables.

RESUMO Objetivo: avaliar a conduta de reconstrução imediata de face e couro cabeludo após mordedura canina em crianças. Métodos: série prospectiva de casos atendidos na Unidade de Emergência do Hospital Regional da Asa Norte, Brasília/DF, no período de janeiro de 1999 até dezembro de 2014. No momento da admissão do paciente à emergência, foi realizado o fechamento primário da ferida proveniente de mordedura em face e couro cabeludo, independente da hora ou dia da agressão. O tratamento primário das mordeduras foi realizado por meio de sutura direta, retalhos ou enxerto, conforme o tipo da ferida e da decisão do cirurgião. Resultados: o estudo compreendeu 146 crianças, sendo que a região zigomática e o couro cabeludo foram os principais sítios das mordeduras na cabeça. Todos os pacientes receberam tratamento cirúrgico dentro das primeiras 24 horas após a admissão. Não houve complicações infecciosas nos casos estudados. Conclusão: os achados sugerem que o fechamento imediato das mordeduras caninas em face e couro cabeludo em crianças é seguro, mesmo quando realizado várias horas após a lesão.

ABSTRACT Objective: to evaluate the immediate reconstruction of face and scalp after canine bites in children. Methods: we conducted a prospective series of cases treated at the Emergency Unit of the Asa Norte Regional Hospital, Brasília - DF, from January 1999 to December 2014. At the time of patient admission to the emergency, the primary wound closure of the face and scalp bite was performed, regardless of the time or day of the event. The primary treatment of the bites was by means of direct suture, flaps rotation or grafting, depending on the type of wound and surgeon's decision. Results: the study comprised 146 children, with the zygomatic region and scalp being the main sites of head bites. All patients received surgical treatment within the first 24 hours after admission. There were no infectious complications in the cases studied. Conclusion: the findings suggest that the immediate closure of canine bites on the face and scalp in children is safe, even when carried out several hours after injury.

From 1995 to 2009, 206 cases of dog bites were recorded among hospitalized patients at the Children National Health of, Lima-Peru. The median of age was 4 years, and for hospitalization time was 3 days. Most patients were males (61.7 %). The bites occurred in the house of a third person (39.3 %), on the street (33.5 %), or in the victim’s house (27.2 %). A 66.5 % of the bites were provoked and 88.8 % were from animals known to the victim. The dog breed was recognized in 34 % (52.9 % were mongrel dogs). Multiple lesions were identified in 79.1 %, and the most frequently bitten areas were head and neck (79.1 %). Complications were reported in 20.4 % and aesthetic sequelae in 94.7 %.

Entre 1995 a 2009 se registraron 206 hospitalizaciones en el Instituto Nacional de Salud del Niño debido a accidentes por mordedura canina. La mediana de edad de los pacientes fue cuatro años y para los días de hospitalización tres. El 61,7 % fueron varones. Los accidentes ocurrieron en el domicilio de una tercera persona (39,3 %), en vía pública (33,5 %) y en el domicilio del agredido (27,2 %). El 66,5 % de los episodios fueron precedidos por un estímulo del niño y el 88,8 % causado por animales reconocidos por los lesionados. El 34,0 % reconoció la raza del animal (52,9 % animales cruzados). El 79,1 % fueron lesiones múltiples y la región anatómica más afectada fueron la cabeza y cuello (79,1 %). Se registraron complicaciones en un 20,4 % y secuelas estéticas en el 94,7 %. Las mordeduras caninas afectan la salud física de los niños.

From 1995 to 2009, 206 cases of dog bites were recorded among hospitalized patients at the Children National Health of, Lima-Peru. The median of age was 4 years, and for hospitalization time was 3 days. Most patients were males (61.7 %). The bites occurred in the house of a third person (39.3 %), on the street (33.5 %), or in the victim’s house (27.2 %). A 66.5 % of the bites were provoked and 88.8 % were from animals known to the victim. The dog breed was recognized in 34 % (52.9 % were mongrel dogs). Multiple lesions were identified in 79.1 %, and the most frequently bitten areas were head and neck (79.1 %). Complications were reported in 20.4 % and aesthetic sequelae in 94.7 %

Entre 1995 a 2009 se registraron 206 hospitalizaciones en el Instituto Nacional de Salud del Niño debido a accidentes por mordedura canina. La mediana de edad de los pacientes fue cuatro años y para los días de hospitalización tres. El 61,7 % fueron varones. Los accidentes ocurrieron en el domicilio de una tercera persona (39,3 %), en vía pública (33,5 %) y en el domicilio del agredido (27,2 %). El 66,5 % de los episodios fueron precedidos por un estímulo del niño y el 88,8 % causado por animales reconocidos por los lesionados. El 34,0 % reconoció la raza del animal (52,9 % animales cruzados). El 79,1 % fueron lesiones múltiples y la región anatómica más afectada fueron la cabeza y cuello (79,1 %). Se registraron complicaciones en un 20,4 % y secuelas estéticas en el 94,7 %. Las mordeduras caninas afectan la salud física de los niños

Animal bites in humans are an important public health problem. Most of these bites are dog bites. The first step in preventing this kind of accident is to identify the associated risk factors. The present article reviews the most important published articles on the incidence of dog bites, their risk factors, and preventive measures. Concerning victim profiles, features such as age, sex, location, and the severity of the wounds are reviewed. Regarding dogs, the most frequent breeds involved and the dog's previous history of aggression are described. In addition, the different contexts in which bites occur are reported. Thus, factors such as dates, number of dogs, places, victim-dog relationship and interaction, and the distinct involved categories of aggression of the canine ethogram are reviewed. The most frequent recommendations found in the literature to reduce and prevent dog bites in the human population are also described.

Las mordeduras de animales a personas suponen un importante problema de salud pública. Dentro de éstas, las más frecuentes son las producidas por perros. Un primer paso necesario en la prevención de este tipo de accidentes es conocer los factores de riesgo implicados. El presente trabajo revisa la bibliografía más relevante en cuanto a la incidencia, los factores de riesgo y la prevención de las mordeduras de perros en personas. Así, según las características de las víctimas, se revisan determinados aspectos, como la edad, el sexo, la localización y la gravedad de las lesiones. En relación con los perros agresores, se describen las razas implicadas y el historial previo del animal. Igualmente, se describen los contextos en que se producen las mordeduras, en relación con la fecha, el número de perros, los lugares más frecuentes, la relación e interacción víctima-perro y la participación de las distintas categorías de agresividad del etograma canino. En el último apartado se recogen las recomendaciones más habituales halladas en la bibliografía para prevenir y reducir la incidencia de mordeduras sobre la población general.

Animal bites in humans are an important public health problem. Most of these bites are dog bites. The first step in preventing this kind of accident is to identify the associated risk factors. The present article reviews the most important published articles on the incidence of dog bites, their risk factors, and preventive measures. Concerning victim profiles, features such as age, sex, location, and the severity of the wounds are reviewed. Regarding dogs, the most frequent breeds involved and the dog's previous history of aggression are described. In addition, the different contexts in which bites occur are reported. Thus, factors such as dates, number of dogs, places, victim-dog relationship and interaction, and the distinct involved categories of aggression of the canine ethogram are reviewed. The most frequent recommendations found in the literature to reduce and prevent dog bites in the human population are also described.

Las mordeduras de animales a personas suponen un importante problema de salud pública. Dentro de éstas, las más frecuentes son las producidas por perros. Un primer paso necesario en la prevención de este tipo de accidentes es conocer los factores de riesgo implicados. El presente trabajo revisa la bibliografía más relevante en cuanto a la incidencia, los factores de riesgo y la prevención de las mordeduras de perros en personas. Así, según las características de las víctimas, se revisan determinados aspectos, como la edad, el sexo, la localización y la gravedad de las lesiones. En relación con los perros agresores, se describen las razas implicadas y el historial previo del animal. Igualmente, se describen los contextos en que se producen las mordeduras, en relación con la fecha, el número de perros, los lugares más frecuentes, la relación e interacción víctima-perro y la participación de las distintas categorías de agresividad del etograma canino. En el último apartado se recogen las recomendaciones más habituales halladas en la bibliografía para prevenir y reducir la incidencia de mordeduras sobre la población general.

OBJETIVO: Avaliar a conduta de reconstrução imediata das mordeduras caninas em couro cabeludo. MÉTODO: Foram avaliados prospectivamente 55 pacientes vítimas de mordedura canina na cabeça, atendidos na emergência do Serviço de Cirurgia Plástica, Hospital Regional da Asa Norte (HRAN, Brasília-DF) de janeiro de 1999 a dezembro de 2001. RESULTADOS: Nove (16,4%) dos 55 pacientes apresentavam lesões extensas de couro cabeludo, dos quais sete eram menores de 10 anos. Nesses nove casos, o tratamento mais utilizado foi a sutura direta (77,8%), seguido pelo enxerto do couro cabeludo avulsionado em 22,2% dos casos. Não houve infecção nos casos estudos. CONCLUSÕES: O fechamento primário das lesões em couro cabeludo após mordeduras caninas mostrou-se seguro.

BACKGROUND: Evaluation of the management of immediate scalp reconstruction after dog bites. METHODS: There were 55 victims of dog bites on the head seen on the emergency room of the Plastic Surgery Unit, Hospital Regional da Asa Norte (HRAN, Brasília, DF, Brazil) from January, 1999 through December, 2001. RESULTS: Nine (16.4%) patients had extense injuries on the scalp. From these patients, seven (77.8%) were less than ten years old. The treatment was suture of the lesion of most cases (77,8%). The other cases (22.2%) were treated with graft of the scalp. There was no infection on this series of cases. CONCLUSIONS: The results indicate that immediate closure of dog bite injuries to the scalp is safe, either by direct suturing or scap grafting.

As mordeduras representam uma lesão comum geralmente vista nas emergências dos hospitais, correspondendo a cerca de 1% dos atendimentos. Os autores conduziram um estudo para avaliar a conduta de fechamento primário das mordeduras na face dos pacientes atendidos na emergência do Serviço de Cirurgia Plástica do Hospital Regional da Asa Norte (HRAN, Brasília-DF) de janeiro a dezembro de 1999. O estudo compreendeu 42 pacientes, com média de idade de 17 anos (variação de um a 50 anos) e 29 (69,0%) dos pacientes eram homens. As mordeduras caninas foram as mais freqüentes (71,4%), seguidas pelas mordeduras humanas (26,2%). O tempo médio entre a agressão e o atendimento no Serviço de Cirurgia Plástica do HRAN foi de 16 horas. A orelha foi o sítio principal (40,0%), seguido pelo lábio. O tratamento utilizado foi a sutura direta em 28 (66,7%) pacientes, retalhos locais em 12 (28,6%) pacientes e enxerto em dois casos. Não houve infecção nos casos estudados. Os achados sugerem que o fechamento imediato das lesões na face é seguro, até em casos após várias horas da lesão.

Mammalian bite wounds represent a common type of injury usually seen in the emergency room, constituting approximately 1% of visits to emergency departments. The aim of this study was to evaluate the management of the bites injuries to the face presenting to Department of Plastic Surgery, Regional Hospital of North Wing, Brasília, Brazil, from January to December, 1999. There were 42 patients, with a mean age of 17 years, ranging between 1 and 50 years: 29 (69,0%) patients were males. Dog bites were responsible for 71,4% of all bite wounds, following by human bites (26,2%). The mean duration of injury before presentation was 16 hours. The ear was the most common site of injury (40,0%), followed by the lips. Surgical treatment consisted of primary closure, either by direct suturing (66,7%), local flap (28,6%) or skin grafting (4,7%). There was no infection in this study. The results indicate that immediate closure of bite injuries is safe, even with older injuries.

Estudou-se a incidência de casos de mordeduras caninas atendidas em uma unidade básica de saúde da cidade de Ribeirão Preto, SP, no período de 1993 a 1997, entre crianças com idades de 0 a 15 anos. Os dados encontrados mostraram a importância de se promover programas educativos sobre os riscos dessas ocorrências para evitar acidentes causados por contatos com cães.

The incidence of dog bites injuries among children aged 0 to 15 years seen at CSE D. Pedro I health center in Ribeirão Preto, Brazil, in the period of 1993 to 1997, was studied. The results show that there is a need to develop and implement educational and preventive programs about the risks and severity of accidents occurred while in contact with dogs.

Estudou-se a incidência de casos de mordeduras caninas atendidas em uma unidade básica de saúde da cidade de Ribeirão Preto, SP, no período de 1993 a 1997, entre crianças com idades de 0 a 15 anos. Os dados encontrados mostraram a importância de se promover programas educativos sobre os riscos dessas ocorrências para evitar acidentes causados por contatos com cães.

The incidence of dog bites injuries among children aged 0 to 15 years seen at CSE D. Pedro I health center in Ribeirão Preto, Brazil, in the period of 1993 to 1997, was studied. The results show that there is a need to develop and implement educational and preventive programs about the risks and severity of accidents occurred while in contact with dogs.