Penetrating neck trauma

Thal, Erwin R.; Meyer, Dan M.

doi:10.1016/0011-3840(92)90031-w

Cited by 46 publications

(19 citation statements)

References 54 publications

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“…It is useful to divide the neck horizontally into 3 zones. Zone I extends between the clavicles and the cricoid cartilage; injuries to this zone carry the highest mortality because of vascular injury and high-risk surgical explorations (4). Zone II is superior to Zone I and extends as far as the angle of the mandible.…”

Section: Introductionmentioning

confidence: 99%

Penetrating Neck Trauma: Review of 192 Cases

Mahmoodie¹,

Sanei

Moazeni-Bistgani

et al. 2012

Arch Trauma Res

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BackgroundThe neck region contains a high density of vital organ structures within a relatively small and unprotected anatomic region, making it one of the most vulnerable areas of the body for all types of injuries.ObjectivesIn this article, we studied penetrating neck trauma cases in Alzahra Hospital over a 10-year period.Patients and MethodsIn this retrospective, descriptive, analytical study, penetrating neck trauma cases admitted to Alzahra Hospital between April 2000 and April 2010 were analyzed for epidemiology, mechanism of trauma, zone of trauma, therapeutic method, injuries to other organs, complications, and mortality.ResultsAmong 192 penetrating neck injuries, the mean age at the time of injury was 25.08 ± 15.02 years. Of these cases, 96.4% occurred in men. The most common mechanisms of trauma was stab wounds (85.93%). In 56.3% of penetrating neck injuries, zone 2 was involved. Neck exploration was positive in 84.4% of cases, and 52.1% of patients underwent surgery. Vascular exploration was the most common cause of surgery (67.2% of patients). The most common surgical intervention was vein ligation (50.8% of cases). In 11.98% of cases, another organ injury occurred simultaneously, and chest injury was the most common coexisting problem (65.2%). Complications were reported in 9.3% of patients, and the need for intubation was the most common complication (5.2% of patients). Mortality rate was 1.5%.ConclusionsAccording to the findings of this study, the most common cause of penetrating neck injuries was stab wounds, and the majority of patients were young men, therefore, preventive measures should be implemented. Because of fatal complications associated with neck injuries, we recommend early neck exploration in unstable cases or when injuries are deeper than the platysma.

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Section: Introductionmentioning

confidence: 99%

Penetrating Neck Trauma: Review of 192 Cases

Mahmoodie¹,

Sanei

Moazeni-Bistgani

et al. 2012

Arch Trauma Res

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“…As injúrias traumáticas dessa região englobam um grande número de lesões em adultos e continuam sendo de difícil manejo. 3 Enquanto a intervenção cirúrgica é necessária em 15 a 20% dos casos (presença dos 'hard sings' ou de instabilidade hemodinâmica) a conduta frente ao paciente estável ainda é tema de discussão. 3,8,12,13 Neste estudo, 79% dos pacientes se encontravam estáveis hemodinamicamente e foram submetidos à cervicotomia em função de dados do exame físico na admissão (64%), de avaliações subsequentes (13%) ou dos resultados de exames de imagem, ressaltando a importância do exame físico seriado.…”

Section: Discussionunclassified

“…Até a década de 40, todas as lesões penetrantes de pescoço eram tratadas de modo conservador, com taxas de mortalidade chegando aos 35%. 3 Em uma tentativa de reduzir as elevadas taxas de mortalidade, a abordagem cirúrgica foi adotada, inclusive para os pacientes estáveis.…”

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Análise Retrospectiva de Pacientes Vítimas de Trauma Cervical Penetrante Submetidos À Cervicotomia

Nasr¹,

Manfrinato²,

Barros³

et al. 2015

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Ana Cláudia Marchi Barros et al 96 RESUMO Objetivos: As lesões cervicais penetrantes são, em sua maioria, causadas por armas de fogo ou armas brancas, e o conceito de um manejo cirúrgico seletivo é o empregado atualmente no tratamento destes pacientes. O presente trabalho tem como objetivos avaliar o perfil demográfico dos pacientes vítimas de traumas cervicais penetrantes submetidos à cervicotomia, quanto à presença ou não de lesão, o tipo de lesão encontrada durante o ato cirúrgico, além da evolução e mortalidade. Métodos: Foram estudadas 57 vítimas de trauma cervical penetrante atendidas no Hospital do Trabalhador, em Curitiba (Brasil), nos períodos de abril de 2009 até março 2014, que foram submetidas à cervicotomia.Resultados: Os principais mecanismos de trauma foram: ferimento por arma branca (52,6%), ferimento por arma de fogo (40%); 61% deles ocorreram em zona II. 91% dos pacientes eram do sexo masculino, com uma média de idade de 33,1 anos. 43,8% destes apresentavam alguma lesão associada e 46% realizaram exame de imagem pré-operatório. Em 82,5% das cervicotomias foi encontrada lesão. As injúrias mais comuns foram: vascular (68%), de vias aéreas (47%) e de esôfago (11%). O tempo operatório médio foi de 118 minutos. 17,5% dos pacientes apresentaram algum tipo de complicação pós-operatória. O tempo médio de internamento foi de 9 dias. Óbito ocorreu em 7% dos pacientes, sendo que todos estes apresentavam lesões associadas. Conclusão:Homens adultos jovens são os mais acometidos. Todos os pacientes que foram à óbito apresentavam algum tipo de lesão associada, mostrando que a cervicotomia foi terapêutica quando existiam lesões cervicais isoladas. No entanto, em uma parte (17,5%) dos pacientes submetidos à cirurgia, nenhuma lesão foi encontrada. Isto mostra que, apesar dos avanços tecnológicos referentes aos exames complementares, mais estudos são necessários para orientar a conduta frente ao paciente vítima de trauma cervical penetrante. ABSTRACTObjectives: Penetrating neck injuries are, for the majority caused by firearms or knives and the concept of a selective surgical management is the current approach in treating these patients. The present work aims to evaluate the demographic profile of patients suffering from cervical penetrating trauma for the presence or absence of injury, the type of injury found during surgery, plus the outcomes. Materials and methods:We studied 57 patients with cervical trauma penetrating treated at Hospital worker in Curitiba (Brazil), in the period Results:The main trauma mechanisms were: stab wound (52.6%), injury by firearm (40%); 61% of them occurred in zone II. 91% of patients were male, with an average age of 33.1 years. 43.8% of them had some associated injury. 46% underwent preoperative imaging. In 82.5% who had surgery injury was found. Common were: vascular (68%), airway (47%) and esophagus (11%). Mean operative time was 118 minutes. 17.5% of patients had some type of complication postoperatively. The average time of hospitalization was 9 days. Death occurred in 7% of p...

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“…Gunshot wounds may not follow a predictable trajectory, and may travel in unexpected patterns if they impact upon bony structures. [83848586] In addition to the path of the bullet, two additional factors must be considered: The blast effect and the possibility of either bullet or bone fragments causing additional injury. Because of this, upper aerodigestive endoscopy and high-definition “thin cut” CT scans should be considered, and further supplemented by other endoscopic and radiographic techniques.…”

Section: Penetrating Neck Injuriesmentioning

confidence: 99%

Trends in nonoperative management of traumatic injuries – A synopsis

Stawicki

2017

Int J Crit Illn Inj Sci

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Nonoperative management of both blunt and penetrating injuries can be challenging. During the past three decades, there has been a major shift from operative to increasingly nonoperative management of traumatic injuries. Greater reliance on nonoperative, or “conservative” management of abdominal solid organ injuries is facilitated by the various sophisticated and highly accurate noninvasive imaging modalities at the trauma surgeon’s disposal. This review discusses selected topics in nonoperative management of both blunt and penetrating trauma. Potential complications and pitfalls of nonoperative management are discussed. Adjunctive interventional therapies used in treatment of nonoperative management-related complications are also discussed.Republished with permission from:Stawicki SPA. Trends in nonoperative management of traumatic injuries – A synopsis. OPUS 12 Scientist 2007;1(1):19-35.

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Penetrating neck trauma

Cited by 46 publications

References 54 publications

Penetrating Neck Trauma: Review of 192 Cases

Penetrating Neck Trauma: Review of 192 Cases

Análise Retrospectiva de Pacientes Vítimas de Trauma Cervical Penetrante Submetidos À Cervicotomia

Trends in nonoperative management of traumatic injuries – A synopsis

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