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Friday, January 3, 2014

Wood Splinter Foreing Body in a Horse

A young mare presented with a baseball-size swelling on the left side of her neck that was just below the jugular groove. Two weeks prior, the mare presented with a puncture wound in the same area and the referring veterinarian removed several splinters. The mare was treated with antibiotics and the wound healed slowly; however, purulent discharge developed recently and the mare was tender to manipulation of the swelling. An ultrasound exam was performed and several linear foreign bodies (yellow arrows) were noted (Figures 1-3).

Figure 1
The linear foreign bodies were approximately 1-2 cm deep in the tissue and ranged in length from 5mm to 20mm (yellow arrows). Most concerning was the close proximity of one linear foreign body with the carotid artery (red circle in Figure 1)!!
Figure 2

Figure 3

 A 6cm incision was made directly over the linear foreign bodies followed by careful dissection of the subcutaneous tissues (Figures 4 and 5). Although the ultrasound exam suggested that the foreign bodies were big and obvious, it was quite tedious to locate the wooden offenders. In this case, 2 weeks had passed since the mare had impaled herself and her body had begun the process of forming thick scar tissue around the splinters, like a cocoon. After what seemed hours, 5 wooden splinters (Figure 6) ranging in size were removed from the mare's neck!!

Figure 4

The wound was lavaged heavily and left open to heal by second intention. It is probable that some wood fragments remain within the wound however their size and the extensive surgical exposure should allow for adequate healing without complications.

Figure 5

Figure 6

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