Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are performed to prevent faecal contamination. Epidural anaesthesia should be performed using either xyalzine alone or xylazine in combination with lidocaine or mepivicaine. The rectum should be packed with an antiseptic tampon positioned cranially to the tear and extending to the anus. A length of stocking filled with betadine-soaked cotton has been recommended for this. A purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered. | Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are performed to prevent faecal contamination. Epidural anaesthesia should be performed using either xyalzine alone or xylazine in combination with lidocaine or mepivicaine. The rectum should be packed with an antiseptic tampon positioned cranially to the tear and extending to the anus. A length of stocking filled with betadine-soaked cotton has been recommended for this. A purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered. |