OBJECTIVE: To evaluate selective operative management in penetrating neck trauma. DESIGN: A chart review. SETTING: A university-affiliated hospital in Johannesburg, South Africa. PATIENTS: All adults admitted to the hospital between January 1988 and June 1993 with a penetrating neck wound. Excluded were patients in whom there was no suspicion of an occult injury that might need further investigation. There were 755 patients in the study. INTERVENTIONS: Immediate surgical exploration (group A, 613 patients) and observation with constant monitoring (group B, 142 patients). MAIN OUTCOME MEASURES: Unnecessary explorations in group A and missed significant injuries in group B. RESULTS: In group A there was a 3% incidence of unnecessary explorations, and 4.2% of the patients died. In group B there was a 9.1% incidence of missed injuries, and 2.8% of the patients died as a result of the delayed diagnosis. Overall the death rate was 4%. CONCLUSION: Selective operative intervention for penetrating neck trauma results in fewer negative explorations and a death rate comparable to those of series that support mandatory neck exploration.
OBJECTIVE: To evaluate selective operative management in penetrating neck trauma. DESIGN: A chart review. SETTING: A university-affiliated hospital in Johannesburg, South Africa. PATIENTS: All adults admitted to the hospital between January 1988 and June 1993 with a penetrating neck wound. Excluded were patients in whom there was no suspicion of an occult injury that might need further investigation. There were 755 patients in the study. INTERVENTIONS: Immediate surgical exploration (group A, 613 patients) and observation with constant monitoring (group B, 142 patients). MAIN OUTCOME MEASURES: Unnecessary explorations in group A and missed significant injuries in group B. RESULTS: In group A there was a 3% incidence of unnecessary explorations, and 4.2% of the patients died. In group B there was a 9.1% incidence of missed injuries, and 2.8% of the patients died as a result of the delayed diagnosis. Overall the death rate was 4%. CONCLUSION: Selective operative intervention for penetrating neck trauma results in fewer negative explorations and a death rate comparable to those of series that support mandatory neck exploration.
Authors: T Fabian; S G Sakka; S Trojan; A Wafaisade; M Mutschler; T Tjardes; B Bouillon; C Probst Journal: Unfallchirurg Date: 2014-06 Impact factor: 1.000
Authors: R D Levy; E Degiannis; C Hatzitheophilou; P Maberti; A Kantarovsky; K D John; R Saadia Journal: Ann R Coll Surg Engl Date: 1997-05 Impact factor: 1.891
Authors: Uttam K Bodanapally; Kathirkamanathan Shanmuganathan; David Dreizin; Deborah Stein; Amit K Reddy; Stuart E Mirvis; Matthew Vasquez; Cassandra Cardarelli; Elizabeth Guardiani Journal: Eur Radiol Date: 2015-10-22 Impact factor: 5.315