Document Detail


Results of mandatory exploration for penetrating neck trauma.
MedLine Citation:
PMID:  7846919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Management of penetrating wounds to the neck remains controversial despite decades of discussion in the literature. We assessed 393 consecutive stab wounds penetrating the platysma operated at our trauma service between January 14, 1991 and September 30, 1992 to evaluate our policy of mandatory neck exploration (NE). Injury to the common (n = 19 cases), external (n = 7), internal carotid (n = 5), innominate (n = 2), subclavian (n = 20), vertebral (n = 12), facial (n = 2), and intercostal (n = 2) arteries; the external (n = 36), internal (n = 65), subclavian (n = 20), and innominate (n = 4) veins; the pharynx/esophagus (n = 21); and the trachea (n = 28) was considered a positive NE (n = 167). 226 NEs were negative. Except for hemiparesis and bruit, the presence of clinical signs (shock, active hemorrhage, hematoma, surgical emphysema, dysphagia, blowing wound) did not predict a positive NE. Clinical signs were absent in 30% of positive NEs and in 58% of negative NEs. Complications of positive NE included wound infection (n = 7 cases), chyle drainage (n = 6), cerebellar stroke (n = 1), pneumonitis (n = 8), reoperation for recurrent hemorrhage (n = 1), subclavian artery graft occlusion (n = 1), bronchopleural fistula (n = 1), and cerebrospinal fluid leak (n = 1). Negative NEs were complicated by a wound infection in four cases and pneumonitis in one case. The mean hospital stay was 4.3 days for those with a positive NE and 1.5 days for those with a negative NE.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J P Apffelstaedt; R Müller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  18     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:    1994 Nov-Dec
Date Detail:
Created Date:  1995-03-08     Completed Date:  1995-03-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  917-9; discussion 920     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Stellenbosch, Tygerberg, South Africa.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Humans
Length of Stay
Middle Aged
Neck / surgery
Neck Injuries*
Wounds, Penetrating / diagnosis,  surgery*

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