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Prophylactic Management of Human or Animal Bite Wounds to Prevent Infection Category of Management Management Cleansing Remove visible dust Cleanse the wound surface with soap and water, saline, 1% povidone�iodine, or 1% benzalkonium chloride Irrigate with a copious volume of sterile saline solution by excessive-pressure syringe irrigationa Do not irrigate puncture wounds; Standard Precautions must be used Wound tradition No for fresh wounds, unless signs of an infection exist Yes for wounds that appear infectedb Diagnostic imaging Indicated for penetrating accidents overlying bones or joints, for suspected fracture, or to evaluate international physique inoculation Debridement Remove superfcial devitalized tissue Operative debridement Yes if any of the following: and exploration � Extensive wounds (devitalized tissue) � Involvement of the metacarpophalangeal joint (clenched fst damage) � Cranial bites by large animal Wound closure Yes for chosen fresh, nonpuncture bite wounds (see text) Assess tetanus immunization Yes statusc Assess threat of rabies from animal Yes bitesd Assess danger of hepatitis B virus Yes an infection from human bitese Assess danger of human immunodefYes ciency virus from human bitesf Initiate antimicrobial therapyg Yes for: � Moderate or extreme chunk wounds, particularly if edema or crush damage is current � Puncture wounds, particularly if penetration of bone, tendon sheath, or joint has occurred � Facial bite wounds � Hand and foot chew wounds � Genital area chew wounds � Wounds in immunocompromised and asplenic folks � Wounds with indicators of infection Follow-up Inspect wound for indicators of infection inside forty eight h aUse of an 18-gauge needle with a big-quantity syringe is effective. 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