Objective: About 35 000 people are victims of animal bites in Germany every year. Eighty percent of them never see or need a doctor. Nevertheless, especially cat bites are a therapeutic problem, because they are like inoculation injuries and are in up to 50% infected. However, the clinical course without intervention cannot be predicted due to multiple variables (microbiological settlement of cats oral cavity, immunobiological state of the patient). The therapeutic range starts with watchful waiting and raise up to operative revision in every case. We present a seton drainage as a new tool for treatment of cat bites. Method: A monofile nonresorbable seton is led through the cat bite in the subcutaneous tissue, stitched out 1” proximally and fixed by a false knot, though the cat bite wound cannot close. After a wound dressing soaked with an alcoholic disinfection fluid, the related upper extremity is immobilized with a splint. Moxifloxacin is given as an antibiotic. The wounds were controlled day by day by the same surgeon (if possible). After clinical recovery of inflammation, the setons were removed, antibiotic ran 2 days longer. Return to work is possible 2 days later. Results: Up to now, 17 patients with hand and forearm bite injuries (cat, 15; dog, 1; Degu [South American hamster], 1) were treated according to the procedure described above. One patient is treated currently. The patients came to hospital between 6 and 48 hours after injury. Clinical findings were pain (n = 17), local swelling (n = 17), local inflammation (n = 17), lymphangitis (n = 3), and fever (n = 1). In 15 patients, the wounds healed without complications. One patient presenting himself 48 hours after cat bite required surgery 24 hours later, and 1 patient developed an abscess 6 weeks later. Conclusion: The successful start with this small number of patients encourages us to continue with this treatment.
