Hanoi doctors warn of heightened dog-bite risks for older adults

Bedridden woman mauled by pet dog

Dr. Vu Giang An of the Orthopedic Trauma Surgery Department at the National Hospital for Tropical Diseases said the first patient was a 73-year-old woman from Hanoi who was transferred to the hospital after being bitten by her own dog.

According to her family, the patient’s household had two dogs weighing about 20 kilograms each. One of the dogs had recently given birth. 

The attack occurred when the woman was cleaning an area where the puppies were kept and the mother dog suddenly attacked her.

Doctors found more than 10 dog-bite wounds on different parts of the woman’s body. Her left upper arm, forearm and hand alone had about seven wounds.

She also had large wounds on her right buttock and knee. One bite to her forearm caused deep tissue damage and an open fracture of the radius.

“This was a severe case. The patient had not only multiple soft-tissue wounds, but also deep injuries that caused an open fracture. Such cases must be assessed as serious trauma, including blood loss, the risk of shock, and potential damage to blood vessels, bones and soft tissue,” Dr. An said.

The patient received rabies post-exposure prophylaxis, antibiotics and wound care. 

Because the wounds were contaminated and at risk of infection, doctors did not immediately close all of them. 

Instead, they continued to monitor the wounds, change dressings and control inflammation and infection.

The second patient, N.T.K., 76, from Hanoi, had been paralyzed for about six years and spent most of her time bedridden. 

She was attacked by a dog while lying in bed and was almost unable to defend herself.

MSc Dr. Le Trung Thanh of the Department of Plastic and Reconstructive Surgery and Interdisciplinary Care at the National Hospital for Tropical Diseases said the force of the bite and tearing caused extensive skin avulsion on the patient’s left forearm. 

The skin and underlying layer of subcutaneous fat were torn away from the tissue beneath, exposing the underlying fascia and muscle.

The area of skin avulsion measured 20 to 25 centimeters in length, extending from the elbow to near the wrist, and was about 10 centimeters wide at its widest point.

The patient received first aid, wound cleaning, surgical debridement and wound treatment. 

During the first few days, the injured area became swollen, red and inflamed.

After about a week, once the swelling and inflammation had subsided, doctors continued cleaning the wound and gradually closed it with loose stitches to reduce its size. 

The patient also received rabies post-exposure prophylaxis and specialized treatment.

Caution needed when keeping dogs around elderly family members

According to doctors, the two cases show that dog bites should not be viewed simply as skin injuries. 

A dog’s teeth, combined with the force of biting, crushing and tearing, can cause much more extensive damage than may be apparent on the surface.

A bite can involve crushed soft tissue, as well as damage to tendons, blood vessels and nerves. In severe cases, it can cause extensive skin avulsion or fractures. 

The risk of infection is another major concern.

Doctors recommend that pet dogs be properly managed and fully vaccinated against rabies. Particular caution is needed when approaching a mother dog that is caring for puppies.

Families with elderly members, people who are paralyzed or those with limited mobility should control their contact with pets, as they may have difficulty protecting themselves if attacked.

Anyone bitten by a dog should thoroughly wash the wound under running water with soap and avoid applying leaves, medication or other substances of unknown origin. 

They should then seek medical attention as soon as possible to have the injury assessed and receive tetanus and rabies prophylaxis as indicated.