Case study: Horse - Sinocutaneous fistula

Updated:

17 March 2014

Surgeon/center:

***

Clinical/experimental data:
  • 1 Horse
  • STE size/profile used: 3x 25mm discs, four week expansion
Comment/observations:
  • The reason for carrying out tissue expansion
    • The horse had under gone sinoscopy of the right frontal sinus in 2011 for a persistent right sided nasal discharge. A trephine hole was made at the time and the skin sutured over to cover the defect. The horse subsequently become systemically ill and the skin wound coving the trephine hole broke down during his further treatment leaving a sinocutaneous fistula
    • Due to the inelastic nature of equine skin especially on the head, there wasn't enough skin to cover the defect.
    • Soft tissue expanders were used to try to create enough excess skin to cover the original trephine site.
  • All STEs expanded although not to the dimensions that were expected (see figure 10)
  • The horse exerted normal behaviour throughout the expansion phase , ate/behaved normally
  • When the devices were removed there was some evidence of bone damage due to excessive pressure from expansion of the devices.
  • All 3 devices which had been originally evenly spaced and secured using stay sutures displaced, each device slipping rostrally, meaning that they expanded more as one large device rather than as three separate devices as originally planned.
  • Reconstruction of the original wound was possible once the devices were removed, which would not have been possible without the extra skin the STEs provided
  • Post-surgery the site has healed fully.  
Photographic record:
Confidentiality:

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