Surgery for severe dog bite saves teen’s smile
By Christina Orlovsky Page
Anyone who has ever known the unconditional love of a dog knows that sometimes there are conditions to that animal’s affection. Every pet has its own personality. Some dogs give off clues that say, “Do not disturb me right now,” while others might convey, “Don’t hug me, I don’t enjoy it.”
It was the second clue that 16-year-old Katie Mendez wishes she would have recognized in her own dog, Floppy, in May, when she hugged him and he snapped at her, slashing the left side of her upper lip so deeply that it required plastic surgery to repair.
“He was lying in my parents’ room and I guess he wasn’t in a good mood,” Katie recalls. “But I went over to him anyway and hugged him and he bit me. It didn’t hurt but I got so scared thinking I’d have to give him up. That made me sad because I’ve had him for eight years.”
A member of the family since he was a puppy, Floppy is a 15-pound terrier mix that Katie says is very friendly with both kids and adults.
“But I guess I sparked his anger,” she says.
The bite happened so quickly that Katie wasn’t aware of how serious it was until she went to the bathroom and noticed the blood. Her family rushed her to the Sam S. and Rose Stein Emergency Care Center at Rady Children’s, where physicians determined that Katie would need plastic surgery.
All too familiar
“A big factor for us in the ER is the location of the bite, and Katie’s bite was in a very important cosmetic location on her face,” explains Stacey Ulrich, M.D., an emergency medicine physician at Rady Children’s and an associate clinical professor at UC San Diego. “We always want the best possible cosmetic outcome, so if the wound is complex and the location warrants it, we have the plastic surgeon come in to close it.”
ER staff cleaned Katie’s wound and sent her home that night. In the morning, she saw plastic surgeon Thomas Vecchione, M.D., also an associate clinical professor of plastic surgery at UC San Diego, who operates on several dog bite victims each week at Rady Children’s. Over the past five years, the Emergency Care Center has seen an average of 250 dog bites each year, or roughly five bites every week.
“Dog bites are very common, especially in the summer,” Dr. Vecchione says. “Very often, it’s a relative’s dog that doesn’t know the child as well, and the child wants to play when the dog doesn’t. The child will get close to the dog’s face, and when the dog tries to move away, its canine tooth will snag on the child’s cheek or lip and tear it.”
Katie’s laceration was so deep that it affected all the muscles in her upper lip and mouth, requiring a three-layer closure with dissolvable stitches that fell out on their own after about a week. As with most dog bite victims, she was prescribed antibiotics to prevent infection. The most important part of the procedure, according to Dr. Vecchione, was the aftercare to ensure proper healing and reduce scarring.
“Post-operative care is a very important part of healing,” he says. “There are a few basic things that reduce scarring: staying out of the sun for six months to a year and protecting the wound with a good sunscreen or even a Band-Aid; keeping warm soaks on the wound for two to three weeks to allow it to heal and keep the edges together; keeping the wound moist with antibiotic ointment for a week to 10 days; and really restricting activity for a few weeks to allow it time to heal. For the long term, various creams, ointments and tapes can be used to refine and decrease the scar noticeably as time passes.”
For Katie, time and proper care have already allowed for near-perfect healing.
“I’m not insecure about it and I don’t try to hide it,” she says. “At first I thought it looked cool!”
What is cool is that Katie feels the incident has brought her and Floppy closer and taught her a
valuable lesson about her furry friend and all dogs in general.
“I love animals and that will never change,” Katie says, “but now that I know he’s capable of biting me like that, I know I have to be more cautious. When he gives me clues, I know now that he’s not just playing around. He doesn’t want to be bothered.”
Beware the bite: Clues to canine body language
When you love a dog as a member of your family, it’s hard to think of the pet as a potential threat. Unfortunately, research has shown that more than 70 percent of bites are from dogs we know and love, and all dogs have the potential to bite, says Kay Moore, R.N., a pediatric trauma nurse at Rady Children’s Hospital-San Diego and a certified professional dog trainer.
The good news is that these bites can be prevented if both adults and children can recognize the clues in their canine’s body language. “Dogs tell us with their bodies when they are uncomfortable and would
rather be left alone,” Moore explains.
According to Doggone Safe, a dog-bite prevention organization that partners locally with the San Diego Chapter of the Emergency Nurses Association (ENA), the following signs indicate impending danger:
■ High, slowing wagging tail, stiff body and mouth closed tight
■ Rapid tongue lick or flick
■ “Half-moon eyes” (showing the whites of the eyes) or head turn, gazing away from what is bothering them
■ Yawning when wide awake
■ Tail and ears tucked close to body
■ “Freeze and stare,” which indicates an impending bite
Doggone Safe and the ENA also suggest the following ways to prevent dog bites:
■ Playing safe games, like fetch, instead of aggressive ones, like tug-o-war or chase
■ Gently scratching your dog’s neck instead of patting his head
■ Never running from your dog
■ Never disturbing your dog while he is eating or sleeping
Finally, do not approach a dog you don’t know without asking the owner first. Watch the dog’s body language cues to see if he wants to meet you; if not, leave him alone.
Originally published in The San Diego Union-Tribune, October 2015