Dog bites can be physically and emotionally devastating injuries — and especially traumatic when the victims are children. In the United States, the dog most commonly responsible for serious bite injuries is the Pit bull (approximately 50% of cases), followed by Rottweilers (approximately 10%) and mixed breeds containing one of those breeds (approximately 5%). Summer months are the most common time for dog bite injuries. Beyond the immediate wound, dog bites carry distinct concerns that distinguish them from other animal injuries: powerful jaw strength and long sharp teeth can produce damage that is significantly deeper than the surface appearance suggests, with potential injury to nerves, tendons, blood vessels, and bones beneath the visible wound. Effective dog bite management requires both surgical wound care expertise and an understanding of the deeper hand anatomy that may be involved. At Los Angeles Plastic Surgery in Beverly Hills, Dr. John Anastasatos manages hand and upper extremity infections and traumatic dog bite injuries with the depth of training this complex injury specifically rewards.

Dr. Anastasatos manages dog bite injuries with the most directly relevant academic credential possible: he completed a fellowship in Hand and Upper Extremity Surgery and Microsurgery at the University of Alabama at Birmingham — formal subspecialty training in hand surgery that few cosmetic plastic surgeons possess. He has presented academic work at UAB Grand Rounds on “Infections of the Hand” — directly relevant to the bacterial management dog bites specifically require — and trained in plastic surgery under Dr. Luis Vasconez at UAB, one of history’s foremost plastic surgeons. With over two decades of facial and hand surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Initial Dog Bite Evaluation

Because the powerful jaw strength of certain dogs can produce injury that is significantly deeper than the surface wound suggests, the initial evaluation must maintain a high index of suspicion for deeper injury:

• Examination for deeper structural injury to nerves, tendons, blood vessels, and bones of the hand, wrist, and forearm
• X-rays to rule out bone fractures
• MRI or CT scan when deep tissue infection or compartment syndrome is suspected
• Tetanus immunization status check — booster recommended if not within the last 5 years
• Rabies prophylaxis evaluation — rabies immune globulin (RIG) recommended if the dog’s immunization history is unknown

Wound Management

Dog bite wound management is matched to the depth and complexity of the injury:

• Simple scratches and puncture wounds — irrigated thoroughly in the emergency room and allowed to heal by secondary intention with proper, guided wound care management
• Deeper but uncomplicated wounds — copious irrigation, debridement of foreign debris and devitalized tissue, then surgical closure
• Complex wounds, face/neck wounds, and pediatric wounds — treated in the operating room under general anesthesia, with copious irrigation using normal saline and antibiotic solution, thorough wound debridement, and removal of all foreign debris
• Extensive injury — when injury is widespread, waiting 48 hours can allow healthy wound tissue to demarcate, enabling more conservative debridement that preserves more viable tissue for reconstruction
• Significant tissue loss — may require additional reconstruction with skin grafts or local flaps

Antibiotic Strategy for Dog Bites

Dr. Anastasatos is a proponent of early antibiotic use for dog bites — a position grounded in the specific bacteriology of these injuries. The most common bacterial organisms responsible for dog bite infection are Pasteurella multocida and Staphylococcus aureus — and the antibiotic strategy must cover both.

The recommended antibiotic strategy:

• First-line oral therapy: Amoxicillin/clavulanate (Amoxil) — covers both Pasteurella and Staph aureus effectively
• Emergency room or operating room IV therapy: Ampicillin/sulbactam (Unasyn)
• Penicillin allergy: Doxycycline or erythromycin — note that doxycycline should not be given to women who may be pregnant
• Additional or alternative coverage: Sulfamethoxazole/trimethoprim (Bactrim) — used alone or in combination

The combination of bacteria involved in dog bites — including the common skin organism Staph aureus alongside Pasteurella — distinguishes them from cat bites and influences antibiotic selection meaningfully.

Schedule a Dog Bite Consultation in Beverly Hills

For dog bite injuries, prompt evaluation by a hand surgeon experienced in trauma and infection management is essential. Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for evaluation and treatment. Contact Los Angeles Plastic Surgery to schedule a dog bite consultation with Dr. Anastasatos.