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| | '''[[Haematoma - Donkey|Haematoma]] | | '''[[Haematoma - Donkey|Haematoma]] |
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| − | '''Definition: the accumulation of free blood under the skin.'''
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| − | Haematomas are quite common as a result of a direct blow such as
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| − | a kick. In the early stages the swelling may seem to be firm, but it soon
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| − | becomes apparent that it is fluid-filled. Pain may be only slight and even
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| − | palpation may not be resented.
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| − | Haematoma can be differentiated from oedema or inflammatory fluid
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| − | by the '''finger press test''' (In the case of oedema, a finger pressed onto the swelling and then removed will leave
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| − | an indent that remains visible for some minutes. If the swelling is inflammatory there
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| − | will probably be no pitting with pressure and in the case of haematoma the indentation
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| − | will disappear immediately the finger is removed). Recurrent haematoma following minor trauma
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| − | should alert the clinician to the possibility of blood-clotting disorders.
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| − | Diagnosis can also be confirmed by a combination of ultrasonography,
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| − | when the fluid nature of the swelling will be appreciated, and by aspiration.
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| − | Haematomas that have been present for some days to weeks show separation
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| − | of plasma/serum and clotted blood. The clot will tend to organize and
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| − | become ultrasonographically denser. At this stage the overlying skin may
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| − | crinkle slightly or may simply be ‘baggy’.
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| − | Management of haematoma is simple according to clinical preference.
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| − | A haematoma can be '''drained''', although there are risks associated with this,
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| − | such as continued haemorrhage or infection. Alternatively, it can be '''left to
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| − | organize'''. There are no definitive rules, but attempts to drain a haematoma
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| − | should not be made too early because the risk of continued haemorrhage
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| − | is higher.
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| − | In the early stages, direct pressure via a firm bandage may limit the size and
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| − | speed up the organization phase, but in some locations it can be difficult or
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| − | even impossible. A stent applied over the site may be sufficient to limit the size.
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| − | Avoidance of any further trauma is important. Direct pressure to the drained
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| − | area is sometimes helpful, but can also be difficult in some locations.
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| − | A scar may be visible as distorted skin, firmly bound down to the
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| − | underlying tissues. Organizing haematomas in some sites, for example a
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| − | penile haematoma, can result in penile deviations, while a haematoma within
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| − | the semimembranosus-semitendinosus region may cause fibrotic myopathy.
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| − | Haematomas that occur within the muscle sheath are particularly painful
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| − | and can result in long-term fibrous metaplasia of the muscle belly with
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| − | consequent loss of function.
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| − | ==References==
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| − | * Knottenbelt, D. (2008) The principles and practice of wound mamagement In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 9
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| − | {{toplink
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| − | |backcolour = D1EEEE
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| − | |linkpage =Wound Types - Donkey
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| − | |linktext =Wound Types - Donkey
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| − | |rspace={{Donkey}}
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| − | |pagetype=Donkey
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| − | }}
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| | '''[[Contusion - Donkey|Contusion]] | | '''[[Contusion - Donkey|Contusion]] |
| | {{review}} | | {{review}} |