Will a large cat bite require stitches?
No. A bite wound, regardless of who inflicted it (dog, cat, human) may never be stitched up! As much as skin sutures are a very proven remedy to address everyday injuries, on bite wounds they are completely counter-productive.
The suppuration forming inside the hand – or any other concerned body part for that matter – must be allowed to drain off. A sealing skin suture would prevent proper drainage of forming pus and by doing so enhance the expansion of the infection subcutaneously.
So when is a surgical approach appropriate?
Many hand surgeons do already find it appropriate to consider surgery as soon as a cat bite or scratch penetrated through all layers of the skin.
What is the point of such early surgery?
The advantage of progressing to surgery fairly quickly is that the amount of damaged tissue which needs removing can be kept relatively scarce and that secondary severe complications from an infection may be kept at bay.
A potential infection can be contained by eliminating the breeding ground for harmful germs. In addition, if thorough wound irrigation within the infectious area is performed during early surgery, the bacteria count can be drastically reduced.
Both measures will at any rate drastically reduce the possibility of a severe infection!
If early surgery was not an option, when does a cat bite need to be treated surgically at the latest?
Any time there is a progressing infection! Considering the high risk of infection associated with cat bite wounds the advantages of early surgery cannot be stressed enough.
The immediate damage caused by the bite (arrow) can hardly be spotted on the skin anymore.
The progressing reddening and swelling represents a compelling necessity for a surgical intervention. Any further delay will inevitably lead to further damages to the injured site and to a prolonged therapy course.
How can the concerned patient tell the progression of the infection?
Over the first hours following a cat bite it would appear that the symptoms recede. If however after hours or days the pain returns stronger than before and if even at night time the patient experiences a throbbing pain at the site of the injury, this unfortunately may already be a clear sign for a progressing infection.
These subjectively experienced symptoms in most cases are also accompanied by an increased swelling and reddening particularly to the back of the hand.
The example seen in the picture makes urgent surgery absolutely mandatory to avoid severe consequential damages.
Should one also keep an eye on a lymphangitis?
One should never wait out an inflammation of the lymphatic system (commonly referred to as blood poisoning).
It is best to avoid a lymphangitis all together!
A lymphangitis is a frequently observed condition associated with a cat bite injury!