Wild Boar-Related Injuries in Wilderness Environments: Field-Oriented Management Principles and Evidence-Informed Clinical Recommendations.

Wild boar-related trauma is uncommon but may result in severe injuries that pose diagnostic and therapeutic challenges, particularly in wilderness or resource-limited environments. Most scientific literature consists of isolated case reports, regional series, and forensic descriptions; clinical guidance is therefore fragmented. This study synthesizes two complementary evidence sources: a structured observational cohort documenting 101 injuries sustained by boar hunters during organized hunts in Germany, and a comprehensive systematic review of all globally published wild boar- and feral pig-related human injuries. The observational cohort provided internally consistent epidemiologic information on who was injured, under what circumstances, how quickly assistance was obtained, and how injuries were treated and ultimately healed. The systematic review added detailed insight into injury morphology and severity across diverse settings, including reports of deep wound tracts, extensive soft-tissue disruption, significant contamination, and the risk of hemorrhage, neurovascular compromise, or thoracoabdominal penetration. The systematic review was conducted in accordance with PRISMA 2020 principles and included explicit study identification, screening, and eligibility assessment. Integrating these sources enabled a field-oriented approach to assessment and management, emphasizing early hemorrhage control, broad-spectrum antibiotic therapy, appropriate use of imaging, thorough surgical exploration when indicated, and region-specific tetanus or rabies prophylaxis. Together, these findings support clinicians working in remote or austere environments who may encounter these rare but potentially serious injuries.