An aged Thoroughbred who was sliced on the cheek. This is an interesting case because instead of having a simple cut to suture the situation turned out to be much worse, he took of a whole piece that was about the size of the palm of my hand. The cut was self inflicted, of course, while the horse was trying to eat some more grass, reaching under the stall walls that were made of tin, very silly of the owner to have the Box in this way.

At first I tried to move the two edges closer with some towel clamps. I had them on while I sutures the lip that also had a fair cut, right through the side of it. That done with I dedicated all my attention and skill as a surgeon ti the facial cut. I quickly found out that there is not enough skin to suture.

A tension suture was elected and revaluation in 18 hours was what seemed to be the only option. At the base of the tention sutures (U shaped, Single interrupted sutures) an small piece of  an IV set line was placed, not to put too much stress on the skin edges so there Will be no necrosis due to ischemia of the blood supply. Towel claps go a long way when trying to suture a place that has a lot of tention.

After 18 hours there was already laying down of fibrin. horizontal tention relieving incisions were made, below and above the suture line. At this time the tention sutures were removed and again using the force of the towel claps the skin edges came together nicely. A staple gun was used to get a very precise suture line and U shaped Single interrupted sutures were put in with the added IV set pieces to minimize the tention on the edges of the suture line.

The result was very satisfying. This all was possible for the use of a lot of Carbocaine, a small amount can go a long way.

Barak Amram DVM