Dealing with Dog Bites: Statistics, Treatments, and Tips for Avoiding Bites Altogether

Donald Laub, MD, FACS, is a plastic surgeon at Fletcher Allen, and a professor at the University of Vermont College of Medicine.

Some of the most distressing but common injuries that I treat are those resulting from a dog’s bite.  Some interesting statistics on dog bites:

• Every 40 seconds, someone in the United States seeks medical attention for a dog bite.
• Dog bites result in approximately 44,000 facial injuries in US hospitals each year.
• Unfortunately, children comprise 60% of the dog bite victims, and the most severe injuries occur in children less than 10 years of age.
• The face is the most frequent target, most often the lips, nose, and cheeks.
• Mail carriers are an exception, in that almost all of their dog bite injuries involve the lower extremities.
• Dog bites cause an average of 18 deaths a year.
• $165 million is spent in the United States for the estimated 800,000 dog bite related injuries requiring treatment each year.

When and where do most dog bites occur?

I see a higher number of these injuries each fall and spring; I think that this is from the change in activity level with the change in weather.  Often dog bite injuries are by pet dogs known to the bitten person. They generally occur close to dog’s home or home of the bitten person. In one study of an urban emergency room of children less than 4 years old, 90% were bitten at home and 47% were bitten by their own dog.  Even when broadly defining provocation, less than half of all injuries are provoked.

What types of dogs are most likely to bite?

Puppies are more likely to bite than an adult dog. While any dog can bite, the top biting breeds include: Pit Bulls, Rottweilers, German Shepherds, Huskies, Doberman Pinschers and Chow Chows. The pit bull terrier is a common cause of urban dog bite injuries in children; in this particular situation, the dog is often freely roaming, and more frequently attacks unprovoked.

What are the physical and emotional impacts of dog bites, and how are bite wounds treated?

Bites from dogs may cause punctures, cuts, abrasions, tissue loss or avulsion, crushing wounds or even fractured bones.  These wounds result in permanent, possibly disfiguring scars. Patients with dog bites first require treatment to prevent infection, tetanus, and possibly rabies. The dog may be quarantined for observation of possible latent rabies. Repair of the wounds may require simple closure, removal of injured tissue, and reconstructive surgery. Underlying nerve, tendon or bone injuries may need repair. Sometimes completely severed tissue can be replaced as a graft or reattached with microsurgical repair of small blood vessels. Occasionally, a plastic surgeon may have to move other tissue into the defect to close or recreate the disfigured feature. Such reconstruction may need multiple operations over several years. Scars are an unavoidable and permanent result of tissue injury. Scars may be improved but never completely removed. Once bitten, a person will frequently become very nervous of dogs. Parents often suffer from shame and guilt when their child is injured.

How can I avoid a dog bite?

Possible dangerous situations are: disturbing a dog while feeding, invading a dog’s territory, a perceived threat to a dog’s owners, or a dog jealous of new family members.  A dog will perceive staring it right in the eye as a challenge. Running from or screaming at a dog may provoke an aggressive response. Children should be taught to be as still as possible if approached by an unfamiliar dog. If a dog knocks them over, they should to roll into a ball and stay still. They should tell an adult if they see a stray dog or one acting strangely. They also should know to be careful to avoid approaching or bending over dogs especially if they are lying quietly, approaching them immediately after entering their territory, teasing or waking them, or playing with them till they become overexcited.

Ten DON’Ts:

• Don’t hold your face close to a dog
• Don’t allow dogs to roam unleashed
• Don’t approach a strange dog
• Don’t tease a dog
• Don’t play aggressive games with a dog.
• Don’t disturb a dog that is sleeping, eating, or caring for puppies
• Don’t leave a small child and dog alone
• Don’t skip vaccination of a dog
• Don’t leave a dog alone with strangers
• Don’t ignore the warning signals of aggressive behavior

Dog owners can help by:

• Spaying or neutering your dog.  Dogs have a calmer disposition after this.
• Training your dog in obedience.
• Keep your dog healthy, as an unnoticed illness or injury can make a dog aggressive.
• Follow leash laws.

 Donald Laub, MD, FACS, is a plastic surgeon at Fletcher Allen, and a professor at the University of Vermont College of Medicine.

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