We recommend that adults and children over 12 wear face masks when attending our clinic, but no longer provide masks to patients and carers. Videoconsultations are conducted via telehealth at our dedicated virtual clinic. We are experiencing high demand for appointments hence require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation. If our surgeons assess that your condition (especially recent injuries) is best managed with hand therapy rather than surgery we may recommend that you see a qualified hand therapist (physiotherapist or occupational therapist) rather than schedule an appointment with our surgeons. Dr Tomlinson does not offer consultations and surgical services where a Medicare Rebatable Item Code does not apply; this includes injections for palmar hyperhidrosis. Dr Tomlinson has scheduled sabbatical leave during much of October, November and December 2023 so will not be available for urgent or emergency referrals during that time.

Animal bites

Created 25 December 2011, last modified 16 December 2012

hand feeding ducks Whether it's a cat bite, dog bite, bird bite or human bite, if you have a bite injury you should seek urgent medical attention. Even if the wound seems minor it is possible that you may develop a severe infection that requires hospitalisation, multiple surgeries and lengthy courses of antibiotics. This is especially so for patients who smoke, or have diabetes or other medical conditions that make them susceptible to hand infections.

If the wound extends through the skin it is recommended that this be explored and thoroughly washed out by a qualified specialist, either in an emergency department or an operating theatre. Broad spectrum antibiotics are recommended, along with a tetanus booster if you are due for this. Splinting and elevation are additional therapies that will reduce the risk of infection.

Signs to watch out for

If you have received a bite injury and you have ongoing or worsening throbbing and pain from the site despite initial treatment this is a sign of infection until proven otherwise. It is imperative that you return to a hospital emergency department or surgical specialist for further assessment and treatment.

Other signs of infection include

redness at the site of the wound
redness spreading up the hand or forearm
pus coming from the wound
swelling
worsening pain on movement
fever
shakes and chills
feeling generally unwell

Signs that you may have received an injury to structures below the skin include

numbness or shooting 'electrical' pain with movement
reduced range of movement or absent movement of a joint
deep pain on movement
spurting blood from the wound

If you have any of these symptoms please seek urgent medical treatment.

Suggested antibiotics

Antibiotic therapy is prescribed in addition to proper washout of your wound. Antibiotic therapy alone is insufficient to overcome a "dirty" wound. Your surgeon will take your allergies and the type of bite into consideration when prescribing an antibiotic; in cases of severe infection advice from an infectious diseases specialist may be sought. If you have a true allergy to penicillin you will not be prescribed an antibiotic that contains amoxycillin.

capsules 200x150 Parakeets - ciprofloxacin or trimethoprim/sulphamethoxazole
Cockatoos - clindamycin
Parrots - amoxycillin/ clavulanic acid
Cats - amoxycillin/ clavulanic acid
Dogs - amoxycillin/ clavulanic acid
Humans - amoxycillin/clavulanic acid
Fish - ciprofloxacin

References

Meyer CL, Abzug JM, Domestic Bird Bites. J Hand Surg (Am) 2012 Apr 24 ePub ahead of print.

Tweets by @MelbHandSurg

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