Characteristics and management of dog bite injuries in the facial region: 10 years of experience at a university hospital in Colombia

Objective: The objective of this study was to characterize the anatomical distribution, severity, and management of facial dog bite injuries in patients treated at a university hospital in Colombia over a 10-year period. Materials and Methods: A retrospective cohort study was conducted, including cases of facial dog bites reported by Hospital Universitario San Ignacio to the National Public Health Surveillance System (SIVIGILA) between December 1, 2013, and December 31, 2023, under the code “Aggressions by potentially rabies-transmitting animals” (INS 300). Data were collected through a standardized review of electronic medical records. Results: A total of 445 patients with 663 facial wounds were analyzed. Males represented 51%, 52% were younger than 18 years, and 19% were under five. The oral region was most affected (31%), followed by cheeks (26%), nasal (13%), and ocular/periocular areas (12%). According to the Lackmann classification, 62% of wounds were superficial. However, 70% required surgical treatment (suturing, debridement, or reconstruction), and 8% underwent reconstructive procedures. Hospitalization occurred in 6% of cases. Children aged 0-4 had the highest need for reconstruction (14% of wounds vs. 4% in adults). Ocular injuries, although less frequent, involved the lacrimal duct in 15% and had the highest reconstructive rate (30%). Increasing Lackmann severity correlated with surgical management, although some mild lesions also required reconstruction. Conclusions: Facial dog bites affect all ages, with young children showing greater severity. Despite many being superficial, a substantial proportion require reconstructive care. The Lackmann classification may not adequately capture clinical severity or guide management in all cases.