The longer people take to seek treatment after suffering a bite wound from someone, the greater their risk the wound will become infected, according to a review of human bite injury cases treated at an Irish plastic surgery unit.

Many victims also failed to get recommended follow-up treatment, Dr. Patricia A. Eadie and her colleagues from St. James Hospital in Dublin found, raising the risk of permanent scarring and functional damage.

"Late-night alcohol-fueled aggression" is the most common cause of such injuries, Eadie and her team report in the Emergency Medicine Journal. Guidelines recommend treating bite wounds like an infected surgical wound, by cleansing the area, removing infected tissue, and closing the wound as quickly as possible.

To better understand the nature of these wounds and their management, the researchers reviewed the cases of all patients who had been referred to their plastic surgery unit for treatment of human bite injuries from 2003 to 2005.

During that period, the researchers treated 92 patients with 96 human bite wounds. In 86 percent of cases, the victim had been drinking. Seventy percent of the bites occurred during the weekend or on a public holiday.

Bites to the face accounted for 70 percent of the injuries, with the ear being the site most commonly affected. Eighteen patients developed infections, and those who waited to go to the hospital for 12 hours or longer after the injury occurred were at the highest risk of infection. Upper limb injuries also were more likely to become infected than injuries to other parts of the body.

After initial treatment, 47 percent of the patients failed to return for follow-up visits, Eadie and her colleagues found. Just 14 percent underwent surgery to reconstruct the affected area, or planned to do so.

"Bite wounds present a challenge to any emergency department given the many issues involved in their management," the researchers conclude. Failing to deal with any of these issues "may result in a potentially devastating complication" involving function, infection or appearance.