Document Detail

Results of mandatory exploration for penetrating neck trauma.
MedLine Citation:
PMID:  7846919     Owner:  NLM     Status:  MEDLINE    
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)
J P Apffelstaedt; R Müller
Related Documents :
10501899 - Percutaneous transluminal angioplasty and stent placement for subclavian and brachiocep...
10388259 - Migraine complicated by brachial plexopathy as displayed by mri and mra: aberrant subcl...
7997899 - An unusual course and relations of the human axillary artery.
25411859 - Ultrasound features of middle cervical sympathetic ganglion.
7350599 - An unusual aberrant left subclavian artery.
17166569 - Subclavian artery puncture repair with angio-seal deployment.
11597039 - High resistive index of the radial artery is related to early primary radiocephalic hem...
644429 - Limitations of portable roentgenography of the chest in patients with acute respiratory...
23633719 - Primary peri-aortic hemangiosarcoma in a dog.
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    
Department of Surgery, University of Stellenbosch, Tygerberg, South Africa.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Length of Stay
Middle Aged
Neck / surgery
Neck Injuries*
Wounds, Penetrating / diagnosis,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Local versus general anesthesia for Shouldice repair of the inguinal hernia.
Next Document:  Expression of basic fibroblast growth factor in hyperplastic parathyroid glands from patients with m...