Surgeons' advice: Prevent dog bites

August 11, 1999

BY CAROLYN POIROT
KNIGHT RIDDER NEWSPAPERS

When his family's pit bull destroyed the face of a 2-year-old Tulsa, Okla., boy last fall, the entire plastic surgery department at the University of Texas Southwestern Medical School in Dallas worked in shifts night and day for 39 hours on the toddler's initial reconstruction.

His cheeks, nose, lower eyelids, facial flesh and muscles had been torn away. Only his eyes and forehead remained when the marathon surgery began.

Two months later, many of the same doctors were involved in reattaching the entire scalp and rebuilding the delicate back of the neck of a 3-year-old Austin boy, assaulted by a Rottweiler.

Both children survived and are doing well, although they face numerous follow-up surgeries.

But the reconstructive surgeons who spend hours cutting, clipping, moving skin and muscle around, reconnecting nerves and blood vessels and sewing children back together after savage dog attacks don't want to talk about the surgical skills involved.

They want to talk about dog-bite prevention.

"These are truly devastating injuries for the children involved," says Dr. Bill Adams, assistant professor of plastic surgery at UT Southwestern.

"The important thing is a significant portion of the 3 million dog attacks on children each year could be prevented with education. That's definitely the message we want to convey," Adams says.

Adams led the surgical team that reattached the scalp sheared off by the Rottweiler and was part of the team that rebuilt the face devastated by the pit bull. Both children were treated at Children's Medical Center of Dallas.

"Those two recent cases are the most spectacular, but I probably have been involved with at least 30 people attacked by dogs in the last nine years. At least five required extensive multiple reconstructive procedures," Adams says. "If we could prevent just one, it would be worth any effort."

Each year, 4.7 million people are bitten by dogs in this country; 800,000 require medical treatment, and about 65 percent of those who end up in hospital emergency rooms are young children, according to the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention in Atlanta.

In 1995-96, there were at least 25 deaths from dog attacks -- 20 of them children, the most recent CDC statistics show. Estimates could be low by as much as 25 percent because of incomplete information on death certificates, CDC officials say.

"Between 1979 and 1996, there were 304 fatalities from dog bites reported in the United States," says Dr. Charles Ginsburg, chairman of pediatrics at UT Southwestern. "The breeds of dog involved in the attacks on children vary; however, Rottweilers, pit bulls and German shepherds account for more than 50 percent of all fatal bite-related injuries."

"Eighty percent of dogs that attack children belong to a friend or family member of the child and aren't strays," Adams says.

Adams also points out that some breeds are notorious for vicious attacks. Chows, pit bulls, Rottweilers and Doberman pinschers shouldn't be around children at all, he says.

"Parents should always monitor children when they are around dogs, particularly dogs they don't know, and family pets should be trained when they are very young to be more socialized," Adams says.

To prevent dog-bite tragedies, the National Center for Injury Prevention and Control recommends:

Realistically evaluate your environment and lifestyle before buying or adopting a dog. Dogs with histories of aggression are inappropriate in households with children.

• Be sensitive to cues that a child is fearful or apprehensive and delay acquiring a dog until a child is comfortable with it.
• Spend time with a dog before buying or adopting one. Use extra caution when bringing a dog into a home with an infant or toddler.
• Spay or neuter any family pet dog to reduce any aggressive tendencies.
• Never leave an infant or young child alone with any dog.
• Properly socialize and train any dog entering the household.
• Immediately seek professional advice from a veterinarian or animal behaviorist if a dog develops aggressive or undesirable behavior.
• Do not play aggressive games or wrestle with a dog.
• Never disturb a dog that is sleeping, eating or caring for puppies.
• Do not pet a dog without allowing it to see you and sniff you first.