Closure of a sinocutaneous wound with a musculoperiosteal pedicle in a horse.

This research article records a successful treatment of a serious facial wound in a horse, which included a sinus and fractured skull bone, using the pedicles of the temporal muscles and underlying periosteum, known as a musculoperiosteal pedicle.

Context and Significance of the Research

• The article discusses the treatment of an uncommon but complicated wound in horses, where the skull’s dorsal aspect, particularly the frontal bones, fractures into the conchofrontal sinus. Such cases can result in bacterial sinusitis, formation of a sinocutaneous fistula, or facial deformity.
• The healing process is often delayed because of concerns about infections that may arise from primary closure. This study describes a case where primary closure was successfully achieved.

About the Case

• The case involves a three-year-old thoroughbred gelding that incurred a facial wound, complicated by a fractured frontal bone exposing the conchofrontal sinus. The cause of the injury remains unknown.
• The horse was referred to the University of Tennessee Large Animal Hospital for treatment. The wound was large and T-shaped, penetrating into the right conchofrontal sinus.
• An endoscopic examination revealed no abnormalities in the nasal cavities or the conchofrontal sinus, other than the visible detached bone fragments from the fracture.

Treatment Method

• The corrective surgery was performed with the horse sedated and standing in stocks. The medications administered included detomidine, butorphanol, gentamicin sulphate, and potassium penicillin, taken intravenously.
• Sedation was maintained throughout the procedure with detomidine and xylazine.
• The wound was cleaned using 4 per cent chlorhexidine and high-pressure lavage with physiological sterile saline.
• The technique was devised to use the pedicles of the horse’s temporal muscles and the underlying periosteum to close the wound.

Implications of the Research

• This research is a significant contribution to veterinary medicine as it documents a successful primary closure of a large equine facial wound complicated by a fracture into the conchofrontal sinus.
• This case study could guide veterinarians in handling similar cases and improving the welfare and recovery of equines suffering from such injuries.