Melbourne Hand Surgery 

Coronavirus update: We will be closed on Wednesday 8 April, but will reopen at 8:30am on Thursday 9 April. 

Melbourne Hand Surgery has mechanisms to protect our patients and staff while we continue to provide healthcare services. All consultations are now conducted via telehealth (phone or videoconference), except where we have previously confirmed the requirement for an in-person physical examination or wound care management.  Only emergency surgery is being conducted in hospitals for the foreseeable future, in keeping with Government directives. 

Due to the change in circumstances we will be closed on Fridays until further notice. If our practice is unable to physically open for business at any point in the coming weeks or months we will communicate this to existing scheduled patients via email and SMS (please do not attempt to reply other than with Y or N to an SMS, as the automated system does not facilitate this). Incoming telephone calls and receipt of voicemail messages may be temporarily affected by such a change. We will use this website banner to update you on changes to our practice and the availability of non-urgent procedures and surgery in the weeks and months ahead. Thank you for your understanding as our entire community works through these unprecedented and rapidly evolving times together (last updated: 4 April 2020).

Animal bites

hand feeding ducksWhether 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 200x150Parakeets - 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.

FRACS

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