  This 50-year-old white male earlier this afternoon was attempting to adjust a cable that a dog was tied to.  Dog was a German shepherd, it belonged to his brother, and the dog spontaneously attacked him.  He sustained a bite to his right lower leg.  Apparently, according to the patient, the dog is well known and is up-to-date on his shots and they wanted to confirm that.  The dog has given no prior history of any reason to believe he is not a healthy dog.  The patient himself developed a puncture wound with a flap injury.  The patient has a flap wound also below the puncture wound, a V-shaped flap, which is pointing towards the foot.  It appears to be viable.  The wound is open about may be roughly a centimeter in the inside of the flap.  He was seen by his medical primary care physician and was given a tetanus shot and the wound was cleaned and wrapped, and then he was referred to us for further assessment.