Management of combat-related facial injuries.

The research article focuses on the management of facial injuries in horses, detailing typical injuries, their usual progression, and suggested treatment methods for optimal healing and minimal deformation.

Facial Lacerations and Healing

• The paper starts with a review of how lacerations (tears or deep cuts) on the soft tissues of a horse’s head usually heal quickly due to a rich blood supply in that region.
• However, injuries to the tongue often go unnoticed, as they rarely cause noticeable eating difficulties.
• Most lacerations, even on the tongue, can heal on their own if left untreated, without causing any loss in function.

Role of Surgery

• However, in some severe cases, especially where deformities could occur, surgery can be necessary to promote healing or amputate a severely compromised part of the tongue.
• Surgical principles that should be followed for optimal outcomes include thorough debridement (removal of damaged tissue), multiple layer closure of the wound, and tension sutures (stitches to hold the wound tightly closed).

Handling Lip and Eye Injuries

• Full-thickness lip lacerations should also be treated surgically with multiple-layer closure and tension sutures for best results.
• Reconstructive techniques have been developed for large lip injuries where primary repair is inadequate, or when there’s a significant loss of tissue.
• The paper emphasizes the necessity of thorough evaluation of eye injuries, as they can range from minor to severe, leading to blindness, disfigurement, or loss of the eye.

Facial Fractures

• The research further talks about fractures to the facial bones, noting that certain fractures – involving the frontal, maxillary (upper jaw), or nasal bones – are often open fractures that need urgent care.
• The clinical signs of such fractures include skin abrasions, epistaxis (nosebleed), facial deformity, crepitus (a crackling sound caused by fractured bones), and pain.
• Both bone and soft tissue reconstruction should be considered to minimize potential complications such as face deformity, infection, sinusitis, and osteomyelitis (bone infection).