Nasal amputation due to donkey bite: immediate and late reconstruction with a forehead flap

Shipkov, Christo

doi:10.1016/j.injury.2004.06.011

Cited by 10 publications

(12 citation statements)

References 19 publications

(14 reference statements)

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“…Because of the great deal of force exerted by an equine in closing its jaws, the severity of injuries may range from mild superficial pressure trauma, cutaneous breaks of the skin, deep lacerations with loss of tissue, and injuries to blood vessels and nerves, to amputations of digits or breast, and fractures [ 7 – 9 ]. These wounds are generally contaminated due to the large number of bacteria in the mouth of horse, and their treatment is difficult.…”

Section: Discussionmentioning

confidence: 99%

Severe injury to the brachial neurovascular bundle and muscles due to a horse bite: a case report

et al. 2021

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Introduction Only a small portion of horse injuries are related to horse bites. In the majority of these occurrences, injuries are minor and self-treated. However, in some cases, the injury may be destructive and limb- and life-threatening. In these instances, the patient requires complex surgery and compound perioperative care. Case report We present the case of a 35-year-old Albanian male farm-worker in whom a horse bite caused an extensive lacero-contusive and avulsive wound to the arm. The wound resulted in injury to the brachial artery, brachial and basilic vein, and biceps and brachialis muscles. Nerve structures and underlying humerus remained intact. The initial management of the severe hemorrhagic shock caused by the bleeding at the site of injury included reconstruction of the brachial artery by interposing saphenous graft and that of the brachial vein by termino-terminal anastomosis. Basilic vein was ligated. The wound was extensively debrided, and after a drain was placed in the wound, biceps and brachialis muscles were reconstructed. The patient received several units of red blood cells and fresh frozen plasma before and after surgery, as well as antibiotic, antitetanic, and antirabies prophylaxes. He had several consecutive necrectomies in the following days. However, due to postoperative sepsis and hemorrhagic shock at time of admission, the patient developed acute renal failure, therefore requiring several hemodialysis sessions. After his general and local condition was stabilized, the patient also underwent several reconstructive surgeries. Conclusion Horse bites of large extent require a multidisciplinary approach. The composition of the team of physicians needed for treatment varies depending on the degree of the injury and eventual complications. In the case of our patient, emergency department physicians, vascular and plastic surgeons, intensive care specialists, nephrologists, and infective care specialists were involved. In different instances, the inclusion of other specialists may be necessary to save and functionalize the limbs of the patient, or save his/her life.

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Section: Discussionmentioning

confidence: 99%

Severe injury to the brachial neurovascular bundle and muscles due to a horse bite: a case report

et al. 2021

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“…Of all reported injuries involving horses, approximately 3% to 4.5% are related to bites [4]. Because an equine can exert a great deal of force in closing its jaws, the severity of injuries may range from minor superficial contusions, abrasions, or lacerations to severe crushing or tearing injuries with damage to deeper structures [5]. Horse-bite infections are typically polymicrobial with a mix of aerobic and anaerobic species.…”

Section: Discussionmentioning

confidence: 99%

Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?

Elghoul¹,

Jalal²,

Bouya³

et al. 2019

Case Reports in Infectious Diseases

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Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle sectioned, the flexor and extensor tendons sectioned and shredded, and the skin shredded. An excisional debridement of devitalized tissue with copious irrigation was performed, and the finger regularized at the level of traumatic amputation with tendon striping followed by coverage of the bone by the radial digital flap with careful clinical and biological monitoring after the surgery. At the last follow-up, the patient revealed no sign of infection, and he returned to his usual activities and has been discharged from care. This wound management, based on a careful examination, a meticulous debridement, and an efficient cleaning with early and targeted antibiotic therapy, might promote good results and avoid dangerous complications.

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“…10 They are rarely the cause of animal bites, 11,12 most often causing significant loss of tissue and crush injury; unlike dog bites that lead to tissue lacerations and abrasions, or cat bites that cause punctures and deep wounds. 13,14 Donkeys have sharp incisors and canines 15 that make their bite particularly dangerous. Similar to the camel, the wide opening of a donkey jaw explains the more frequent occurrence of loss of tissue substance and crush injury instead of punctuate lesions or skin abrasions.…”

Section: Case Discussionmentioning

confidence: 99%

Domestic donkey (Equus africanus asinus) bites: An unusual aetiology of severe scalp injuries in Morocco

Droussi

Amrani

Dlimi

et al. 2014

African Journal of Emergency Medicine

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Nasal amputation due to donkey bite: immediate and late reconstruction with a forehead flap

Cited by 10 publications

References 19 publications

Severe injury to the brachial neurovascular bundle and muscles due to a horse bite: a case report

Severe injury to the brachial neurovascular bundle and muscles due to a horse bite: a case report

Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?

Domestic donkey (Equus africanus asinus) bites: An unusual aetiology of severe scalp injuries in Morocco

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