Animal Bite Wound Cleaning
Use running tap water or sterile saline solution to thoroughly irrigate animal bite wounds until all visible debris is removed—antiseptic agents like povidone-iodine offer no additional benefit and should not be used. 1
Irrigation Technique and Solution Selection
The 2024 American Heart Association and American Red Cross guidelines establish that running tap water is as effective as sterile saline for wound irrigation and superior to antiseptic solutions 1. Multiple studies demonstrate similar infection rates whether wounds are irrigated with tap water, boiled water, distilled water, or sterile saline 1. Critically, povidone-iodine and other antiseptic agents provide no demonstrated benefit beyond simple irrigation 1.
Key irrigation principles:
- Continue irrigation until no obvious debris or foreign matter remains in the wound 1
- Use adequate pressure to remove bacterial contamination—simple rinsing may be insufficient 1
- A 20-mL or larger syringe, or a 20-gauge catheter attached to a syringe, provides appropriate irrigation pressure 2
- Remove superficial debris during cleaning, but avoid aggressive debridement that causes additional tissue damage 1, 3
Critical Management Steps Beyond Cleaning
Immediate medical evaluation is mandatory for any animal bite wound or wound contaminated with animal saliva 1. These wounds carry significantly elevated infection risk, with cat bites infected 50% of the time and dog bites 15-20% of the time 3.
After irrigation with tap water or saline 1:
- Explore the wound for tendon or bone involvement and foreign bodies 2
- Assess neurovascular function including pulses and sensation 4
- Evaluate range of motion of adjacent joints 4
Common Pitfalls to Avoid
Do not use iodine-containing or antibiotic-containing solutions for wound irrigation 1, 3—the evidence clearly shows no benefit over plain water or saline. The FDA drug label for topical bacitracin explicitly warns against its use in animal bites 5, reinforcing that topical antibiotics have no role in initial wound management.
Do not close most bite wounds 1, 3. Primary closure is contraindicated except for facial wounds, which may be closed after meticulous irrigation and prophylactic antibiotics 1, 3. Wounds presenting more than 8 hours after injury should never be closed 6, 3.
Post-Cleaning Management
After proper irrigation, cover clean wounds with an occlusive dressing to promote healing 1. Elevate the injured extremity if swollen to accelerate healing 1, 6.
Antibiotic prophylaxis with amoxicillin-clavulanate is first-line therapy 1, 6, 3 and should be strongly considered for hand wounds, puncture wounds, cat bites, and wounds presenting more than 8 hours after injury 3.
Ensure tetanus prophylaxis is current—administer if more than 10 years since last dose for clean wounds or more than 5 years for contaminated wounds 1, 3. Assess rabies risk based on animal species, geographic location, and circumstances of the attack 3, 2.
Human and animal bite wounds require follow-up within 24 hours 6, 3. Signs requiring immediate re-evaluation include redness, swelling, foul-smelling drainage, increased pain, or fever 1.