February 2009
Dr Gerhard Steenkamp

You arrive back at your clinic after a long weekend and see the following patient in your hospital.
 

This Bullterier suffered a jaw fracture during a dog fight, the day before and was temporarily stabilized by your locum.  On closer examination you find that the mouth has been closed completely.

a) Critically evaluate the application of this tape muzzle.
b) What complications can occur with the application of a tape muzzle as presented in this case?

Memo

a) The tape muzzle is stuck to the patient.

The muzzle is secured by sticking it to the patient’s skin in stead of a loop around the head
No space is left for this patient to eat, drink or pant.
An elastic tape (Elastoplast) was used in stead of a non-elastic tape like Micropore.

b) Tape stuck to the skin makes it impossible to remove the muzzle for regular cleaning in emergencies as when the dog needs to vomit.

This will increase the risk of moist dermatitis of the face as food and or saliva accumulates.  It also compromises the patient’s heat exchange ability and makes it impossible for the dog to eat or drink.  Although the author is not adverse to the use of an elastic tape, it does increase the aftercare as these devices do absorb more moisture and may increase the risk of dermatitis.

Force feeding this patient via a syringe into the side of the mouth may increase the risk for aspiration through feeding.  In this specific case, several bite wounds were enclosed under the tape and therefore could not have been treated appropriately

The owners of this dog practiced poor tape muzzle hygiene on this patient and it presented with moist dermatitis a few days after discharge

 
With the Bullterier in dorsal recumbency, the ventral aspect of the intermandibular area is visible (after removal of the Elastoplast) clearly showing several bitewounds that was occluded by the tape muzzle.