Management of human bites of the face in Enugu, Nigeria

Background: Human bites of the face present to the surgeon sometimes with a dilemma as to the method and timing of surgery. Often patients present with soft tissue defects as a result of the injury sustained. Reconstruction therefore becomes absolutely necessary to avoid psychosocial complications. Objectives: The aim of this paper is to review human bites of the face, which presented to the Plastic Surgery Department of the National Orthopaedic Hospital, Enugu, Nigeria over a 10-year period and highlight the epidemiology, presentation, management and its outcome. Methods:A retrospective review of the cases of human bites of the face that presented within a ten year period was carried out. Sources of information were the case notes and operation registers. Information obtained includes age, gender of the patients as well as that of the assailants and the relationship of the assailants to the patients. Sites of the injuries, management and outcome were also obtained. Results:There were 54 patients seen and treated during the period with the age range 16-54 years (Mean age, 33.8±2.3).The male to female ratio was 1:1.6.Various surgical procedures including wedge excision and direct closure (for the lip); midline forehead flap cover, composite auricular graft and nasolabial flaps (for the nose) were carried out.Three of the 9 noses bitten were skin grafted and 3 had primary direct closure. Few complications occurred. Conclusion:We conclude that human bites still remain common in our environment.These sometimes need reconstruction due to loss of parts. Minimal debridement with primary closure/reconstruction of human bites of the face; when presented early, gives a good result.