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Facial dog bites in children: A public health problem highlighted by COVID-19 lockdown - 09/12/23

Doi : 10.1016/j.jormas.2023.101671 
Adèle Rohee-Traore a, , Alexis Kahn a, Roman-Hossein Khonsari b, Nathalie Pham-Dang c, Claire Majoufre-Lefebvre d, Christophe Meyer e, Joël Ferri f, Olivier Trost g, David Poisbleau h, Jihane Kimakhe i, Amélie Rougeot j, Audrey Moret k, Raphaëlle Prevost l, Gaoussou Toure m, Manel Hachani m, Marie DeBoutray n, Boris Laure o, Aline Joly p, Jean-Daniel Kün-Darbois a
a Department of Oral and Maxillo-facial surgery, Angers University Hospital, 4 rue Larrey, Angers 49100, France 
b Department of Maxillo-facial and Plastic surgery, Necker-Enfants Malades University Hospital, 149 rue de Sèvres, Paris 75015, France 
c Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, 58 rue Montalembert, Clermont-Ferrand 63000, France 
d Department of Maxillo-facial surgery, Pellegrin University Hospital, Rue de la Pelouse de Douet, Bordeaux 33076, France 
e Department of Maxillo-facial surgery, Besançon University Hospital, 3 boulevard Alexandre Fleming, Besançon 25030, France 
f Department of Oral and Maxillo-facial surgery, Lille University Hospital, 2 avenue Oscar Lambret, Lille 59000, France 
g Department of Oral and Maxillo-facial surgery, Rouen University Hospital, 37 boulevard Gambetta, Rouen 76000, France 
h Department of Maxillo-facial and Plastic surgery, Grenoble University Hospital, Avenue des Maquis de Grésivaudan, La Tronche 38700, France 
i Department of Maxillo-facial surgery and stomatology, Vendée Hospital Center, Boulevard Stéphane Moreau, La Roche-sur-Yon, 85000, France 
j Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Allée des Topazes, Saint-Denis 97400, France 
k Department of Maxillo-facial surgery and stomatology, Aix Hospital Center, Avenue des Tamaris, Aix-En-Provence 13100, France 
l Department of Maxillo-facial surgery, Ré-Aunis Hospital, 44 rue Moulin des Justices, La Rochelle 17022, France 
m Department of Maxillo-facial surgery, Lucie et Raymond Aubrac Intercommunal Hospital Center, 40 Allée de la Source, Villeneuve Saint Georges 94195, France 
n Department of Maxillo-facial surgery, Gui de Chauliac University Hospital, 191 Avenue du Doyen Gaston Giraud, Montpellier 34295, France 
o Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Avenue de la République, Chambray-lès-Tours 37170, France 
p Tours University Hospital, Avenue de la République, Chambray-lès-Tours 37170, France 

Corresponding author.

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Abstract

Background

Stay-at-home injunction during COVID-19 pandemic led to new dynamics in households and increased the risk of domestic accidents involving pets. The aim of the study was to demonstrate an increase of facial dog bites in children during first lockdown period in France, compared to the same period in 2018 and 2019. Secondary objective was to investigate the demographics and circumstances in which dog bites occurred.

Methods

A retrospective multicentric study was conducted nationwide. Patients under 18 years old managed in fifteen oral and maxillofacial surgery departments for a dog bite were included.

Results

Eighty-seven patients were included. A significant increase of the number of children managed for facial dog bite was noticed in 2020 (p = 0.0005). The male-to-female ratio was significantly reversed in 2020 with more bites in girls than boys (p = 0.02). In 2020, children were mostly bitten to cheeks (28.6 %), lips-and-chin region (26.2 %), and eyelids (23.8 %). Severe bites increased in 2020, in comparison with 2018 and 2019. Dog bites occurring while petting or playing significantly increased in 2020 (31 %) (p = 0.03).

Conclusion

The process leading to bites is highly dependent on the balance of dog-owner relationship. This was strongly disrupted during COVID-19 pandemic, resulting in the increase of dog bites in households. Regarding dog bites, face is the most vulnerable area in children. Its injury has lots of esthetic and functional consequences and maxillofacial surgeons have a key role to play in their prevention. Reminders of some of these management and prevention strategies are presented in this article.

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Keywords : Child, COVID-19, Dog bite, Lockdown, Reconstructive surgery, Trauma


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