Suturing, if required, should be delayed for a few hours to allow RIG to diffuse through the tissues before further trauma.
If suturing is necessary to control bleeding and in severe bites, first infiltrate the wound with RIG with as much amount as is possible anatomically and then loosely suture.
Facial wounds may need to be sutured early to avoid disfiguration. This may be done ONLY AFTER careful local infiltration with RIG
If the wound are very large and bleeding a lot, a simple clean dressing may be done after thorough washing, antiseptic and RIG application
If some local applicants have been applied e.g. chili powder, neem leaf juice, turmeric powder etc., it is important to remove these by flushing with running water while wound washing.
Maximum advantage of washing is gained if it is done immediately after the bite, still
• Even if the bite victim informs late, the wound management must still be performed.
• This is because the virus can persist and even multiply at the site of the bite for a long time.
Reference:
1. Government of India, National rabies control programme, National guidelines on rabies prophylaxis, National Centre for Disease Control, 2019, Delhi, India.
2. Government of Himachal Pradesh: GUIDELINES FOR RABIES PROPHYLAXIS AND INTRADERMAL RABIES VACCINATION IN HIMACHAL PRADESH, 2019. Directorate of Health Service, Swasthya Sadan, Kasumpti, Shimla-171009
signs & symptoms of rabies in brief: http://www.ihatepsm.com/blog/signs-and-symptoms-rabies-brief
Categorization of animal bite: http://www.ihatepsm.com/blog/post-%E2%80%93-exposure-prophylaxis-rabies
Steps of immediate wound management in animal bite: http://www.ihatepsm.com/blog/steps-immediate-wound-management
Rabies Vaccination: http://www.ihatepsm.com/blog/rabies-vaccination
FAQs regarding Rabies and Vaccination: https://ihatepsm.com/blog/dog-%E2%80%93-bite-frequently-asked-questions-...
Post-Exposure Prophylaxis (PEP): http://www.ihatepsm.com/blog/post-%E2%80%93-exposure-prophylaxis-rabies
Rabies Vaccine: http://www.ihatepsm.com/blog/rabies-vaccine