The spectrum of animal related injuries managed at a major trauma centre in South Africa

  • E U Wessels University of the Witwatersrand
  • V Y Kong University of KwaZulu-Natal
  • J Buitendag Stellenbosch University
  • S Moffat University Hospitals Coventry and Warwickshire NHS Trust
  • R Weale North West Deanery
  • A B Ras University of KwaZulu-Natal
  • M Ras University of KwaZulu-Natal
  • M T D Smith University of KwaZulu-Natal
  • G Laing University of KwaZulu-Natal
  • J L Bruce University of KwaZulu-Natal
  • W Bekker University of KwaZulu-Natal
  • V Manchev University of KwaZulu-Natal
  • D L Clarke University of the Witwatersrand
Keywords: animal related injuries, major trauma centre, spectrum, South Africa

Abstract

Background: Humans come into contact and interact with an array of animals in a number of areas and environments. We set out to review our experience with animal-related injuries in Pietermaritzburg, KwaZulu-Natal, South Africa.

Methods: All patients who sustained an injury secondary to an interaction with an animal in the period December 2012–December 2017 were identified from the Hybrid Electronic Medical Registry (HEMR).

Results: There were 104 patients in the study sample. The mean age of patients in the study was 32.8 years, with a range from 1 to 76 years old. 75% (n = 78) were male and 25% (n = 26) female. Out of the 104 animal related injuries, 67 were blunt trauma, 39 penetrating trauma and 3 a combination of blunt and penetrating trauma. The species causing trauma included dogs (53), horses (29), cows (18), buffalo (1), warthog (1), impala (1) and a single goat (1). The median time from injury to hospitalisation was 46.62 hours (range from 0 to 504 hours). Injuries occurred to the head (n = 32), face (n = 9), neck (n = 32), abdomen (n = 22), urogenital system (n = 6), upper limb (n = 39) and lower limb (n = 39). The Injury Severity Score (ISS) mean for the patients was 8.16, the range 1–4, the median 9 and the standard deviation 6.88. In 49 patients the treatment was non-operative. In the remaining 55 patients, a total of 68 operative procedures were required. Operations included wound debridement/surgical washout (n = 38), laparotomy (n = 9), arterial repair/ligation (n = 8), skin graft (n = 4), craniotomy (n = 5), fasciotomy (n = 2), amputation (n = 1), and placement of an ICP monitor (n = 1). 49 of these operations were for patients with dog bite injuries. The mean hospital stay was 0.13 days with a range of 0–4 days. Four patients were admitted to the Intensive Care Unit (ICU) and two patients died.

Conclusion: Human interactions with animals may result in injuries which require surgical treatment. The most common animal injury is a dog bite but in the case of the larger domestic farm animals, blunt force type injuries and goring can result in significant injuries which require complex surgical interventions.

Author Biographies

E U Wessels, University of the Witwatersrand

Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa

V Y Kong, University of KwaZulu-Natal

Department of Surgery, University of the Witwatersrand and Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

J Buitendag, Stellenbosch University

Department of Surgery, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa

S Moffat, University Hospitals Coventry and Warwickshire NHS Trust

Department of Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom

R Weale, North West Deanery

Department of Surgery, North West Deanery, Manchester, United Kingdom

A B Ras, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

M Ras, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

M T D Smith, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

G Laing, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

J L Bruce, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

W Bekker, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

V Manchev, University of KwaZulu-Natal

Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

D L Clarke, University of the Witwatersrand

Department of Surgery, University of the Witwatersrand and Department of Surgery, University of KwaZulu-Natal, Durban, South Africa

Published
2019-08-10
How to Cite
Wessels, E., Kong, V., Buitendag, J., Moffat, S., Weale, R., Ras, A., Ras, M., Smith, M., Laing, G., Bruce, J., Bekker, W., Manchev, V., & Clarke, D. (2019). The spectrum of animal related injuries managed at a major trauma centre in South Africa. South African Journal of Surgery, 57(3), 54. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2854
Section
Online Articles