Published: 2019-04-29

Pattern and management of bear maul injuries in tertiary hospital in Kashmir

Tariq Ahmed Mala, Syeed Rayees Ahmad, Shahid Amin Malla


Background: Bears are very powerful and strong animals that defend themselves and their young ones if they feel insecure once disturbed by humans. Encroachment of forest land and haphazard construction has led to increase in the conflicts between humans and animals. Our valley is surrounded by forests all around and lush green forest area is habitant of black bears (Ursus thiabetanus). The aim of this study was to report and manage these complicated injuries.

Methods: This study was conducted for a period of two years and all the patients were received in the surgical casuality in Government Medical College Srinagar. A total of 32 patients were registered in the two years period.

Results: A total of 32 patients were studied, majority of patients were males. Maximum number of patients was in the age group of 31 to 40 years. All patients had soft tissue injuries; bone involvement was seen in 13 patients. Deep lacerations were seen in 22 (68.75%). Primary suturing was done in 12 (37.5%) of patients, split skin grafting in 7 (21.87%). All 32 patients had ugly scar in follow up with loss of vision in one eye in 3 (9.37%) patients. Four patients were advised psychiatric consultation and further treatment.

Conclusions: Conflicts between humans and bears are common in bear-prevalent areas of the world. Bear maul injuries should be evaluated in detail as some patients may have serious injuries which need multispecialty treatment to maintain cosmetic and identity of a person.


Black bear, Facial injury, Multimodality treatment

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Acharya KP, Paudel PK, Neupane PR, Köhl M. Human-wildlife conflicts in Nepal: patterns of human fatalities and injuries caused by large mammals. PloS One. 2016;11:e0161717.

Joshi AR, Garshelis DL, Smith LD. Home Ranges of Sloth Bears in Nepal: Implications for Conservation. J Wildlife Managmnt. 1995;59(2):204-14.

Shah AA, Mir BA, Ahmad I, Latoo S, Ali A, Shah BA, et al. Pattern of bear maul maxillofacial injuries in Kashmir. Natl J Maxillofac Surg. 2010;1(2):96–101.

Bunnell FL, McCann RK. The brown or grizzly bear. In: Stirling I, ed. Bears, Majestic Creatures of the Wild. Emmaus, PA: Rodale Press; 1993: 88-97.

Dhar SA, Butt MF, Farooq M, Mir MR, Wani ZA, Afzal S, et al. Pattern of orthopaedic injuries in bear attacks: report from a tertiary care centre in Kashmir. Injury. 2008;39:249-55.

Frank RC, Mahabir RC, Magi E, Lindsay RL, de Haas W. Bear maulings treated in Calgary, Alberta: Their management and sequelae. Can J Plast Surg. 2006;14:158–62.

Floyd T. Bear-inflicted human injury and fatality. Wilderness Environ Med. 1990;10:75–87.

Middaugh JP. Human injury from bear attacks in Alaska: 1900-1985. Alaska Med. 1987;29:121–6.

Bashir SA, Rasool A, Zaroo MI, Wani AH, Zargar HR, Darzi MA, et al. Bear maul craniocerebral trauma in Kashmir valley. J Craniofac Surg. 2013;24:2-5.

Wani ML, Ahangar AG, Lone GN, et al. Vascular injuries after bear attacks: incidence, surgical challenges and outcome. J Emerg Trauma Shock. 2011;4:20-2.

Rose SE. Bear mauling in Alaska. Alaska Med. 1982;24:29–32.

Tough SC, Butt JC. A review of fatal bear maulings in Alberta, Canada. Am J Forensic Med Pathol. 1993;14:22–7.

Jethani J, Nagori R, Ghodadara B. An unusual case of bear bite with severe loss of tissue. Indian J Ophthalmol. 2006; 54:287–8.