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Toby's Ear Haematoma
Toby was a black Labrador that was brought in with a severe aural haematoma.
This occurs when the ear flap fills up with blood usually following severe ear scratching or an injury to the ear. If the haematoma is not drained and corrected the pinna will gradually shrink to form a "cauliflower ear" which may remain uncomfortable for life.
In these pictures you can see how swollen Toby’s ear is…

Toby has been given a general anaesthetic, and the ear has been clipped and prepared for surgery by cleaning thoroughly with an antiseptic solution.

A swab is placed in the ear to prevent dirt from the ear canal contaminating the surgical site.
The area is then ‘draped’ with a sterile cloth to improve aseptic conditions, leaving just the ear exposed. A scalpel blade is used to cut (incise) the skin of the inside of the pinna, and all the fluid is drained off into a bowl. See how much there is!

The initial incision is extended into an S shape along the length of the pinna. This curved incision avoids the scar distortion of the pinna that can occur if a straight incision is used.
Pairs of buttons (one on each side) are then meticulously sewn across the surface of the pinna, to hold the inner and outer skin layers close against the cartilage and to bring the incision edges into close apposition.

Buttons spread the load of the sutures and prevent them from cutting through the skin. They also prevent further fluid filling. Once healed haematomas rarely recur as the inner and outer layers of skin become bonded firmly to the ear cartilage. Antibiotics are given to prevent any infection, and non-steroidal anti-inflammatory drugs (NSAIDS) are given to reduce swelling and inflammation, and provide pain relief. These may be extended to a longer course depending on severity. The dog may have to wear a ‘Buster’ collar ( a plastic Elizabethan collar) to prevent interference with the wound.
After a few days the buttons are removed during a routine consultation.

Jill Macdonald   DipAVN(surg). V.N.

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