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Michael Callaham, MD
Highland General Hospital Oakland, Calif

JAMA. 1981;246(8):833.

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In Reply.—

Space limitations did not permit a detailed discussion of wound-edge excision in my article on dog bite wounds. This technique consists of the usual debridement of devitalized tissue, followed by carefully trimming off about 5 mm of the wound edge with a scalpel. It does not refer to total excision of the entire wound. Producing a straight and properly squared-off edge requires some practice, but no more so than other common suturing techniques. Most dog bite wounds can be closed easily and rapidly by this method by any physician experienced in suturing. The complications listed by Dr Lehv are all theoretically possible, but only likely in situations where much larger quantities of tissue are removed. Dr Lehv's experience that "most dog bite wounds are reasonably clean, sharp, and linear" is unusual. Virtually all physicians have found otherwise, and they therefore recommend such debridement and limited excision. Cases involving . . . [Full Text PDF of this Article]

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