Dog Bites of the Head and Neck: An Evaluation of a Common Pediatric Trauma and Associated Treatment

Jan–Feb, 2015 | By Daniel C. O'Brien, BS, Tyler B Andre, MD, Aaron D. Robinson, MD, and Lane D. Squires, MD

A retrospective review of 334 dog bite injuries from a level 1 trauma center in Sacramento. One third of all injuries were caused by pit bull terriers and resulted in the highest rate of consultation.

Study highlights

  • In this study, 334 unique dog bites were identified, of which 101 involved the head and neck. Of the more than 8 different breeds identified, one-third were caused by pit bull terriers and resulted in the highest rate of consultation (94%) and had 5 times the relative rate of surgical intervention when compared to other breeds. Unlike all other breeds, pit bull terriers were relatively more likely to attack an unknown individual (+31%), and without provocation (+48%).
  • The objectives of this study, performed at the University of California Davis Medical Center, a level I trauma center in Sacramento, include the following: 1) describe the patient population that suffer dog bites in the head and neck, 2) determine the dog breeds and circumstances responsible for these head and neck injuries, and 3) evaluate the current treatment and follow-up care associated with dog bite injuries of the head and neck.
  • Of the 334 bites, 101 involved the head and neck. The mean age of the patients with head and neck bites was 15.1 ± 18.1 years (range 11 months to 73 years, median of 6). This value is significantly less than the general dog bite population where the mean age was 28.6 ± 21.5 years (range 11 months to 95 years, median of 26). Of these patients with head and neck bite injuries, 57% of them were below the age of 10, and bites to the head and neck accounted for 70% of all the dog bite injuries experienced by individuals under the age of 18.
  • Bites from pit bull terriers were more severe than those of other dogs, with a mean DBCI of 3.2 compared to 2.3. Bites from pit bull terriers had a significantly higher rate of consultation when compared to other breeds, receiving specialty care in 94% of the cases and in 50% of the cases, respectively. Injuries from pit bull terrier bites were significantly more likely to require surgical repair and had five times the rate of operative repair when compared to other breeds.
  • The key finding from our second objective, determining the dogs responsible for bites, is the importance of pit bull terriers in patients with dog bites of the head and neck. The findings of this study are consistent with and extend from previous publications. Dog bites from pit bull terriers, compared to bites from all other dogs are more common, more severe, and not related to the dog being provoked.
  • Taken as a whole all other breeds are more likely to bite their owners or other known individuals, either provoked or unprovoked. Pit bull terriers, to the contrary, were found to be more likely to bite a stranger without provocation. Also of note, of the dog bites reported to the Sacramento City Clerk, 204 of the 622 were perpetrated by pit bull terriers.
Dog Bites of the Head and Neck: An Evaluation of a Common Pediatric Trauma and Associated Treatment, by Daniel C. O'Brien, BS, Tyler B. Andre, MD, Aaron D. Robinson, MD and Lane D. Squires, MD, American Journal of Otolaryngology, January–February, 2015, Volume 36, Issue 1, Pages 32–38.