medicina60巻4号

2023年04月発行

増刊号 探求！マイナーエマージェンシー Ⅸ．動物のエマージェンシー

飼いイヌに手を咬まれました—動物に咬まれたときはどうするの？

著者： 岩田和佳奈¹

所属機関： ¹JA広島総合病院救急・集中治療科

ページ範囲：P.218 - P.223

POINT
●感染を防ぐことが大事！　まずは洗浄・デブリードマンをしっかりとしよう．
●縫合するかしないかは感染リスクと整容面を天秤にかけて決めよう．
●咬傷後の感染リスクは，ネコ＞ヒト＞イヌ！　ネコは感染必発！　パスツレラ感染に注意を．
●破傷風予防も忘れずにやろう．

参考文献

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9）Seegmueller J, et al：Cat and dog bite injuries of the hand；Early versus late treatment. Arch Orthop Trauma Surg 140：981-985, 2020

10）Bech CM, et al：Bite wounds from dogs, cats and humans. Ugeskr Laeger 183：V11200832, 2021

11）Rasmussen D, et al：Evaluating and treating mammalian bites. JAAPA 30：32-36, 2017

12）Stevens DL, et al；Infectious Diseases Society of America：Practice guidelines for the diagnosis and management of skin and soft tissue infections；2014 update by the Infectious Diseases Society of America. Clin Infect Dis 59：e10-52, 2014

13）Tabaka ME, et al：Predictors of infection from dog bite wounds；Which patients may benefit from prophylactic antibiotics? Emerg Med J 32：860-863, 2015

14）Centers for Disease Control and Prevention：Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 21：Tetanus.　https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html（2022年10月閲覧）

15）Kretsinger K, et al：Preventing tetanus, diphtheria, and pertussis among adults；Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices（ACIP）and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee（HICPAC）, for use of Tdap among health-care personnel. MMWR Recomm Rep 55：1-37, 2006

16）Rupprecht CE, et al：Use of a reduced（4-dose）vaccine schedule for postexposure prophylaxis to prevent human rabies；Recommendations of the advisory committee on immunization practices. MMWR Recomm Rep 59：1-9, 2010