Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University28210.18499/2070-478X-2013-6-4-483-488UnknownTo the Question of Surgical Tactics in Children with Facial Bites<span>Surgeon, the Department of Maxillofacial Surgery, Nizhny Novgorod Regional Children Hospital</span>author@vestnik-surgery.com<span>MD, Professor, the Department of Hospital Surgery named after B.А. Korolyov, Nizhny Novgorod State Medical Academ</span>author@vestnik-surgery.com<span>Head of the Department of Maxillofacial Surgery, Nizhny Novgorod Regional Children Hospital.</span>author@vestnik-surgery.comNizhnii Novgorod Regional Children Hospital, Nizhnii Novgorod, Russian FederationNizhnii Novgorod State Medical Academy, Nizhnii Novgorod, Russian Federation24122013644834882804201628042016Copyright © 2013, ., ., .2013Relevance Treatment of children with facial bites is known as an unresolved medical and social problem. Questions of surgical tactics are discussed to date. The purpose of the study To study of possibilities of new tactic approach in treatment of children with facial bites. Matherials and methods 84 children with facial bites were observed in Nizhnii Novgorod Regional Children Hospital (2002 – 2012). In the basic group were included children, who was operated in Nizhnii Novgorod Regional Children Hospital (n=70). In the control group were included patients, who were operated in hospitals of us region in the first step, and later were treated in Nizhnii Novgorod Regional Children Hospital (n=14). In the groups were no significant distinction on gender, age, basic trauma and intercurrent diseases. Results and their discussion Complications rate in the basic group was two times lower than in the control. Treatment of children with bite wound of the face in special children hospital with multidisciplinary approach led to decrease of complications and better esthetic results. Conclusion The traditional concept of treatment in children with facial bites, including delivery of the patients to the nearest hospital and perform all the necessary actions in the health primary care, needs to be revised. Transportation of children to involve a multidisciplinary hospital at a cost of time, but does not reflect negatively on the quality of care. Children with facial bites should be delivered immediately after the trauma in the specialized surgical center. In first-aid care should be hemostasis and applying aseptic dressing. Diagnostic and surgical procedures carried out without intermediate steps, directly in the department of oral and maxillofacial surgery, lead to significantly better immediate and long-term results, both clinical and esthetic. This approach is associated with significant reduction of complications rate and reconstructive operationsFacial bites, facial wounds, children, complicationsРаны лица у детей, осложнения[1. Akhadov T.A., Dorovskikh G.N. Magnitnyy rezonans][vizualizatsiya ostroy cherepno-mozgovoy travmy u detey. [Magnetic resonance imaging of acute cranial trauma in children.] // Children surgery. 2008; 6: 8–11.][2. Beloborodova N.V. Shchadyashchiye rezhimy terapii antibiotikami v pediatrii. [Sparing regimens of antibiotic therapy in pediatrics.] // Consilium Medicum. 1999; 6: 11–16.][3. Bogatov V.V. Prikus rany chelyustno-litsevoy oblasti:analiz polozheniya v Tverskoy oblasti. [Bite wounds of the maxillofacial region: an analysis of the situation in the Tver region.] // Stomatology, 2009; 5: 34–36.][4. Brostiuk R.B. Vybor anesteziologicheskogo obespecheniia][pri esteticheskikh operatsiiakh na litse i shee [Choice of][anesthetic management for aesthetic operations on the face][and neck. Cand. Diss. Med. Sci.]. // Ekaterinburg, 2010; 96.][5. Grigorovich I.N. Regulirovaniye ukhoda za det'mi][s ostrymi khirurgicheskimi zabolevaniyami v khirurgicheskikh otdeleniyakh dlya vzroslykh [The regulation of care for children with acute surgical diseases in surgical wards for adults.] //Surgery. 2009; 12: 38–42.][6. Dekhtiar S.K. Adekvatnoye ambulatornoye lecheniye khirurga travmatologa detyam po prichine opasnosti razvitiya beshenstva (beshenstvo). [Adequate ambulatory care of the surgeontraumatologist to children couse of the danger of development of a hydrophobia (rabies).] // Children surgery. 2001; 3: 35–39.][7. Kliukvin I.Iu. Lecheniye travm ot ukusov sobaki i koshki: opyt, vozmozhnosti i problemy. [Treatment of injuries from the bites of dogs and cats: experience, opportunities, and problems.] // Russian Medical Journal. 2005; 3: 52–57.][8. Korsak A.K. Petrovich N.I. Osobennosti kliniki i lecheniya ukusov u detey [Features of clinic and treatment of bite wounds in children face.] // Medical Journal. 2012;2: 73–75.][9. Liubyi V.V. Lechenie detei s ukushennymi ranami][cheliustno– litsevoi oblasti, nanesennymi sobakami][[Treatment of children with dog bitten wounds of the][maxillofacial area. Cand. Diss. Med. Sci.]. // Poltava, 2004.][10. O sovershenstvovanii meropriiatii po profilaktike][zabolevaniia liudei beshenstvom. [On the improvement of prevention activities rabies people] // RF Federal Law № 297][07.10.97. Available from URL: http://zakon.law7.ru/base48/][part3/d48ru3930.htm.][11. Petrushin A.L. Ukus kisti [Brush bite wounds.] // Ekology men. 2010; 8: 61–64.][12. Plekhanov V.I. Lecheniye bol'nykh s ukusami [Treatment of patients with bite wounds.] // The success of modern science. 2006; 12: 71–72.][13. Profilaktika beshenstva. [Health regulations] // 3.1.7 2627–10. Available from URL: http://rospotrebnadzor.ru/documen/postanov/.][14. Pshenisnova E.S. Rezul'tat rekonstruktsii nosa posle ukusa sobaki. [The result of nose reconstruction after a dog bite.] // Annaly plastic, reconstructive and aesthetic surgery. 2005; 3: 106–107.][15. Rabukhina N.A. Stomatologiia i cheliustno–litsevaia][khirurgiia. Atlas rentgenogramm [Odontology and maxillofacial surgery. Atlas of roentgenograms]. // Moscow:Medical News Agency Publ., 2003: 295 p.][16. Fomenko I.V. Kharakteristika travmaticheskikh][povrezhdenii cheliustno–litsevoi oblasti u detei,][nakhodiashchikhsia na statsionarnom lechenii [The][characteristic of traumatic damages of maxillofacial area in children who are hospitalized. Proc. Volgograd State Medical University]. Volgograd, 2009; 66: 432.][17. Hon K.L. Voprosy, svyazannyye s ukusami sobak u detey i podrostki otseneny v otdelenii neotlozhnoy pomoshchi. [Issues associated with dog bite injuries in children and adolescents assessed at the emergency department.] // Pediatr Emerg Care. 2007; 23(7): 445–453.][18. Kesting M.R., Hölzle F., Pox C., Thurmüller P., Wolff K.D. Ukus zhivotnogo golovy: 132 sluchaya [Animal bite injuries to the head: 132 cases.] // Br. J. Oral Maxillofac. Surg. 2006; 44(3): 235–239.][19. Walker T., Modayil P. Ukus sobaki - perelom nizhney chelyusti v 9-mesyachnogo mladentsa: otchet dela. [Dog bite – fracture of the mandible in a 9 month old infant: a case report.] // Cases Journal. 2009, 2: 44.][20. Wolff K.D. Rukovodstvo ukusov zhivotnich na litse:opyt raboty s 94 patsiyentami [Management of animal bite injuries of the face:experience with 94 patients.] // J. Oral Maxillofac. Surg. 1998;56(7): 838–843.]