J. A. Ricci1, C. R. Vargas1, O. A. Ho1, D. Singhal2, B. T. Lee1 1Beth Israel Deaconess Medical Center,Division Of Plastic Surgery,Boston, MA, USA 2University Of Florida Health System,Division Of Plastic Surgery,Gainesville, FL, USA
Introduction: Society’s fear of sharks is caused by the media hype surrounding attacks and by movies. Although few sharks are considered dangerous, attacks on humans can result in large soft tissue defects; necessitating the early intervention of reconstructive surgeons. This study aims to determine the characteristics of shark related injuries so that they may be better treated.
Methods: The Global Shark Accident File, maintained by the Shark Research Institute (Princeton, NJ) is a compilation of all known worldwide shark attacks. Database records since 1900 were evaluated to identify differences between fatal and non-fatal attacks. Characteristics evaluated for both fatal and non-fatal attacks included: victim age, victim gender, geographic location of attack, anatomic injury pattern, shark species, and the victim’s activity at the time of attack. The T-test and Chi-Squared tests were used to analyze the data for significant features between the groups.
Results: Since 1900 there have been 5034 shark attacks, with 1205 (24.0%) fatal attacks and 3829 (76.0%) non-fatal attacks documented. While the number of reported attacks per decade has increased, the percentage of attacks that were fatal has decreased. Bites to the legs (41.8%) or arms (18.4%) were most common, with limb loss occurring in 7% of attacks and no injuries in 14.2% of incidents. Characteristics of fatal attacks included swimming (p = 0.001), boating (p = 0.001), three or more anatomical bite sites (p = 0.03), limb loss (p = 0.001), bites to the torso (p = 0.05) or Tiger shark attack (p = 0.002). Non-fatal attacks tended to be associated with fishing (p = 0.001), surfing (p = 0.001), only one anatomical bite site (p = 0.001), bites to the hands or arms (p = 0.001) and bites to the legs (p = 0.001). Geographically, the majority of attacks occurred in North America (1847; 36.7%), followed by Australia (1335; 26.5%) and Africa (676; 13.4%). Within the United States, the individual states with the highest number of attacks were Florida (896; 49.1%), California (248; 13.6%) and Hawaii (240, 13.2%).
Conclusion: Although rare, shark attacks cause devastating injuries to patients. These injuries often involve multiple bite sites and limb loss which can create significant challenges for surgeons by limiting the available reconstructive options. A proper evaluation of the characteristics of the attack can lead to the development of optimal, well-coordinated care plans and improved patient outcomes.