What are the potential benefits and harms of suturing mammalian bite wounds?

BEEM Bottom Line

Why is this study important?

The 2014 Infectious Disease Society of America (IDSA) guidelines for mammalian bite wounds recommend against primary wound closure.[1]  The exception is facial wounds where closure is recommended following copious irrigation and antibiotic prophylaxis. The citations supporting these recommendations are between 30 and 48 years old and are low quality evidence. Wounds at high risk of rabies are a special case: they should not be closed or undergo delayed, loose approximation so that regionally infiltrated Rabies Immunoglobulin can take effect.[2] It is unknown whether suturing bite wounds not at risk for rabies increases the infection rate or changes the appearance of the scar.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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