More horse head injuries

I have many stories of horses with injuries, especially around the head and neck.

Horses are naturally prone to flee when they are spooked. Many times this causes them to wheel around and run into fences, tree limbs, posts, and more.

Here is the most recent severe head injury I have been treating.

This horse was turned out in a back pasture for a few days, so no one knows when or how the injury occurred. It was definitely not a fresh injury.

Here you can see the injury to the right side of the face. You can’t only look at the open wound, you must remember to step back and evaluate the whole horse.

There are two things here to notice.

1. – The nose is “crooked”. This means that the nerves running there have been injured or severed. We have to be sure the horse can still chew and swallow.

2. – The right eye is smaller than the left. We need to examine the eye carefully for damage.

Now for the open wound. Here is the original wound as found by the owners:

It is definitely old and dirty. That black hole beneath the eye is missing bone and exposed sinus cavity.

Here it is after sedation and debridement (medical term for surgical cleaning):

We cannot close this wound because it is contaminated, even after a thorough cleaning. Also, with the wound being this old, the skin and tissues are swollen and impossible to pull back together. But we can’t just leave it open. It would stay dirty, and flies would be everywhere. We need a bandage, but how can we bandage this giant head wound?

The answer is a tie-over bandage. It’s a combination of suturing and bandaging.

In this picture you can see I’ve added some “stitches” (medically correct term is sutures) on both sides of the wound. If you look closely, you can see small pieces of tubing (from an IV line) which will help us use this as a part of the bandage.

Now we will use non-stick bandage material (I like diapers) to cover the wound and tie it in place using the sutures.

The horse is on systemic antibiotics, anti-inflammatories for pain and swelling, and will be kept alone so no other horse can disrupt the bandage.

The owners can untie the cords to change the bandage daily to every other day. We are using honey as a topical medication under the bandage.

Here is the first update, 6 days after I treated it:

It looks very good! No signs of infection or dead tissue. That’s a healthy pink bed of granulation tissue, which will grow and continue to fill in the defect. The sutures are holding well and the horse is not being difficult for bandage changes, which means he isn’t painful. He is also eating and drinking well, letting us know his facial nerves aren’t going to be a long-term problem.

Next update 2 weeks after initial injury:

The sutures are getting loose, which is ok. The wound is much smaller. The yellow exudate is normal for an open wound.

At 17 days out, the wound is really starting to close nicely. The skin is growing at a rapid pace.

Here is where we are just two days ago, 23 days after the original injury.

As you can see, horse injuries tend to heal very well if cared for properly.

This week I will remove those bandage sutures and see about getting it to close up all the way.

I will update as it heals completely.

PS. I apologize for the recent silence. Life has been busy, and I haven’t made time for my blog. I will do better!!

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