With the protection of crocodile species in Far North Queensland it was proposed that an increase in crocodile related injuries could be expected. The aim of this paper was to prospectively follow any crocodile injuries admitted for treatment at the Cairns Base Hospital and to establish a treatment regime for these injuries.

A database was created in 2000 and patients admitted for treatment at the Cairns Base Hospital were followed prospectively. Prior to 2000 chart reviews were undertaken back to 1993. The injuries sustained, place of attack, wound infections and treatments were reviewed. Approval for this study was obtained from the ethics committee.

The majority of patients treated over that period of time were attacked in the wet season and occurred in the water or at the waters edge. All of the injuries were related to the extremities, except for a single case of multiple abdominal lacerations. All wounds were contaminated with positive swab cultures at the time of their initial debridement. Four of these wounds developed a deep infection. In the majority of wounds adequate debridement, temporary stabilisation, and subsequent definitive surgery and skin coverage (coupled with appropriate antibiotic coverage) related in fracture healing.

Avoidance of attack is the best form of defence. If exposed to crocodile wounds then surgical debridement, antibiotic coverage with keflin, gentamicin and metronidazole and delayed stabilsation will result in successful fracture and soft tissue healing.