Understanding Pediatric Dog Bite-Related Craniofacial Injuries: Caregivers' Perspectives on Mental Health and Injury Prevention.

BACKGROUND

Pediatric dog bite-related injuries are a significant public health concern. Dog bite-related injuries frequently involve the craniofacial complex and may carry psychosocial sequelae. We compared clinical characteristics of craniofacial versus non-craniofacial injuries and assessed caregiver perspectives on prevention and mental health needs.

METHODS

Pediatric patients with a history of dog bite-related injuries were identified in the medical record. Caregivers were contacted to complete a survey to assess their perspectives on injury prevention and mental health needs. Patient demographics and injury characteristics were collected. Group comparisons used χ2 /Fisher's exact tests and Mann-Whitney U tests. Independent associations were assessed using multivariable logistic regression.

RESULTS

Of 458 pediatric patients identified, 225 caregivers completed follow-up calls, and 125 completed the survey. Among respondents, 111/225 (51.6%) injuries were craniofacial. Compared with non-craniofacial injuries, craniofacial cases involved younger age at injury (median 5 [IQR 3-7] versus 8.5 [4-11] years, P <0.001), deeper/complex wounds ( P <0.001), and a greater need for surgical intervention (13.8% versus 1.8%, P <0.001). Among surveyed caregivers (n=125), 72% endorsed the need for better safe-pet-ownership education, 63.2% believed education could have prevented the incident, and 83.2% believed mental health services should be offered; however, only 4/125 (3.2%) reported post-bite mental health​​​​ care for their child.

CONCLUSIONS

Craniofacial dog bites in children are associated with younger age, more severe wounds, and higher procedural needs. Despite strong parental support, few children received post-bite psychological care. Our findings identify that caregivers support psychological services and found that utilization was rare. Implementing trauma-informed screen-and-refer pathways and targeted prevention education may address unmet needs.