Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India

Abstract

Ram Kumar Siddharth1 , Shanti Prakash Kujur2 , Pitamber Ram Shivhare3 , Pallavi Vasant Gulhane4 ,

BACKGROUND Bear injuries are unusual, but a trend is often observed in areas of bear habitats. Northern part of Chhattisgarh, a tribal belt is surrounded by bear habitat dense tropical moist deciduous forest. Industrialization and human invasion in their habitats resulting in frequent attacks by bear and victims present to the health care center with grievous injuries and psychological trauma. METHODS Present study included 50 victims of bear attacks admitted in the Department of Surgery, Government Medical College, Ambikapur, Surguja, Chhattisgarh, from 2016 to 2018. Data included are age, sex, precision time of attack, seasons, body parts involved, types of injuries and activity of victims during attack including the course of management. RESULTS In our study of 50 cases, most of the victims were attacked early in the morning and most of the attacks were in winter and monsoon. Common age group encountered was young adults to middle age ranging from 21-40 years. Out of 50 cases studied, 31 (62%) were males and 19 (38%) were females with a male: female ratio of 1.63:1. Attacked victims were usually engaged in cattle grazing activity (40%) and common tendency of attack observed was on face in 46%, followed by scalp in 24% and upper limb in 14%. Commonest injuries made in chronological order were laceration 76% followed by punctured wound in 48%, and avulsion injuries in 16%. Common major complications observed were wound infections 26%, followed by wound dehiscence 10%, with a fatality rate of 4%. CONCLUSIONS Human and bear interactions are accidental and unusual, but frequency is found to be increasing due to encroachment of forest by humans. Victims are usually villagers of near forest. Face and scalp are most commonly attacked body parts but no part is spared and the attack is sometimes fatal. Laceration injury was most common, and mostly on the face and scalp. Management of bear injury required multispecialty approach due to the variety of injuries with involvement of eye, ear, fractures, head injury including reconstruction surgery, to minimise complications.

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