Craniofacial injuries in bear mauling cases in Nepal; Our experience and management

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Naulakha Namrata and Agrawal Manish

Biratnagar Hospital Pvt Ltd, Nepal
Birat Medical College Teaching Hospital, Nepal

: J Health Inform Manag

Abstract

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In Nepal, bear mauling cases are very commonly reported in remote areas along the dense forest where natural habitats are diminishing and composite trauma centers are not available; hence, the final outcome for these patients will not be significantly satisfactory. Bears are herbivorous and do not usually attack unless they are provoked. There are very few literatures available on bear bite management in maxillofacial practice. Usually, bear mauling cases present to emergency department with severe craniofacial injuries with varying patterns is always a challenge for maxillofacial surgeons thereby limiting the use of common protocol for the management. Oral & maxillofacial surgeons, an architect of face not only provide adequate tissue coverage but also functional rehabilitation and camouflage. Bear mauling have the highest incidence approximately 51.2% of all wild animal attacks. Bear bite injuries to Head and Neck region not only results to facial disfigurement but also create serious functional and psychological problems. The main objective of this article is to provide function as well as esthetic by maxillofacial rehabilitation to the victims. This clinical report describes the management of three cases of bear mauling, GCS score of all three patients were full 15/15. To prevent development of rabies, post exposure prophylaxis was given, Human rabies Immunoglobulin 600 IU I.M. as a single dose followed by Injection Rabipur I.M. at0,7,14,21,28 days as preventive measures. To prevent wound infection antibiotics, 4.5gm piperacillin and tazobactam and metronidazole 500mg I.V. BD were given for 7 days followed by Tab. Amoxiclav 625 mg and Tab. Ciprofloxacin 500mg BD were given for 14 days, to all the patients. In all the cases the osteosynthesis was performed from pre existing lacerations.

Biography

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Namrata Naulakha has completed BBS from Tribhuvan University, Nepal in 2010 and MBS from Tribhuvan University, Nepal in 2014. Currently, she is working as a Senior Officer at Biratnagar Hospital Pvt Ltd, Biratnagar, Nepal.

E-mail: dr.agrawal.manish@gmail.com