Old eyelid laceration

Re: Old eyelid laceration

Hannah Wynne Richards — Wed, 21 Nov 2012 11:10:18 GMT

Owners can be the downside of this job

Wynne

Re: Old eyelid laceration

Busybee — Tue, 20 Nov 2012 18:27:52 GMT

I did give antibiotics as it was unknown how it did it and we were leaving it a couple of days before stitching and the owner wasn't able to bathe the eye.

I don't know if NSAIDs are going to work seeing as she decided she knew better and didn't give them! But I hope they would....

Re: Old eyelid laceration

vs0u — Tue, 20 Nov 2012 18:08:07 GMT

Sounds nasty - hope it does ok (and hope the owner settles down too....)

Out of interest did you give antibiotics?

And would NSAIDs work for reducing swelling in that way? I fell off my bike the other week and it never occurred to me to take NSAIDS to reduce swelling - but worth knowing for the future if they do!

Re: Old eyelid laceration

Busybee — Tue, 20 Nov 2012 17:58:21 GMT

Well cat turned up Monday morning, late and with a full stomach! So was delayed until today.

Managed to get a good look once under GA - swelling not resolved much, likely due to the fact that the owner hadn't followed instructions to give loxicom over the weekend.....Actually a very nasty laceration - pretty much big flap extending from the medial canthus of the right eye up at a 45 degree angle and about 1.5cm long. Conjunctiva under flap massively swollen and inflamed. Managed to judiciously debride both edges and closed as neatly as possible. I think the cat will be lucky if it ends up with no complications from this but was pretty chuffed with the appearance immediately post-op!

Unfortunately very awkward owner in this case - moaning at every step, complaining about fees, having to come back for post-op check and reluctant to give meds. Nice cat and only 7 months old....such a shame :(

Re: Old eyelid laceration

Jo Cobbett — Sat, 17 Nov 2012 13:56:20 GMT

We had a dog in this week with a similar wound. My colleague saw it on Wednesday afternoon with 2 lacerations in the eyelid (at opposite ends of the lid so almost the whole eyelid was a flap), perpendicular to the margin and approximately 3-4 mm long. She gave it antibiotics and booked it for repair on Thursday morning. I saw it for admission on Thursday morning and the lid was still very swollen. The central section of the lid was about 2-3 times thicker than the lateral and medial sections. I postponed the surgery for 24hours and gave it an NSAID as I thought it would be easier to suture if the two sections we were suturing together were of equal thickness, and the sutures would hold better in less inflamed tissue. He came back in yesterday morning, when the swelling was much reduced and had the lid sutured. It came together really nicely, and didn't need any additional debridement.

In your case I would have allowed time for the swelling to resolve. You'll probably get a nicer repair that way, as you'll be suturing tissues of the same thickness together, and won't have to allow for resolution of swelling when trying to line up the eylid margin.

Re: Old eyelid laceration

Rob Davis — Sat, 17 Nov 2012 10:43:59 GMT

I would also have gone for your approach - allow the swelling to resolve first.

Re: Old eyelid laceration

Rajat — Sat, 17 Nov 2012 03:38:21 GMT

I'd normally wait 12-24 hours if severe swelling and not longer - obv not always possible with the weekend and so on. But I agree on not operating immediately.

Re: Old eyelid laceration

Evelyn Barbour-Hill — Fri, 16 Nov 2012 23:05:41 GMT

I'd say your plan was correct.

Re: Old eyelid laceration

Michael Woodhouse — Fri, 16 Nov 2012 21:44:54 GMT

I'd have got on with it, but I'm not good at 'wait and see'.

Nothing wrong with your course of action, but the Sx may be harder.