Dogs bite millions of people around the world every year. Since most people who are bitten by dogs do not seek medical attention, the true incidence is unknown even in areas with excellent medical surveillance. What is known is that the severity of the bites from dog attacks range from negligible to lethal, and that bites to the hand and face are both frequent (especially in children) and potentially disfiguring. The dog's mouth harbors a number of pathogenic bacteria, and there is some agreement that bites to the hand are most prudently treated with antibiotics even without signs of infection. Although most lethal injuries from dogs come from the extent of trauma from the attack itself, there have been cases of serious (and even fatal) infections from minor dog bites. These are generally in people with underlying immune problems or who have abnormalities of the heart valves.
Although precise statistics are not available on dog attacks, there have been studies that indicate that the chance of being bitten by a dog is partly determined by geographic region. "The range in reported incidence is wide; interviews with families in Hermosillio, Mexico, in 1988 revealed an annual incidence of 2497 dog bites per 100,000 population...(whereas) ] data from a surveillance network in Switzerland suggest there are 190 dog bites and 80 cat bites per 100,000 persons annually in that country."(reference for quote- Ellen J. Weber:Chapter 58 – Mammalian Bites in Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice, 6th ed.)
Most dog bites in adults involve the lower extremities, but the incidence of facial, scalp, neck and upper extremity bites is significant in adults and high in children. Although the teeth of most dogs are rather blunt as compared to other carnivores, the pressure of the closed jaw is 200 lb per sq inch (or more in some broad headed breeds like Rottweilers and bulldogs). Dog bites are therefore prone to causing crush injury to soft tissues.
===Surgical care===