Selective surgical management of zone II gunshot injuries of the neck: A prospective study

Sofianos, C; Degiannis, Elias; Aardweg, Machteld S. Van den; Lévy, Richard; Naidu, Mireshini; Saadia, Roger

doi:10.1016/s0039-6060(96)80084-5

Cited by 44 publications

(25 citation statements)

References 11 publications

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“…The protocol for assessing and treating patients with PNI is based on haemodynamic and airway status, together with a thorough physical examination. The initial management of gunshot and knife injuries is similar, as previous studies found no significant difference in the rate of successful SNOM between them 6,15 . Transmidline gunshot wounds, however, have a significantly higher rate of injury than other PNIs 18 .…”

Section: Discussionsupporting

confidence: 51%

See 1 more Smart Citation

Management of penetrating neck injuries

Waes¹,

Cheriex²,

Navsaria

et al. 2011

British Journal of Surgery

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Section: Discussionsupporting

confidence: 51%

“…Mandatory neck exploration would not have been useful. The value of routine CTA in patients with transmidline gunshot wounds remains debatable, especially when the patient is fully conscious 15 .…”

Section: Discussionmentioning

confidence: 99%

Management of penetrating neck injuries

Waes¹,

Cheriex²,

Navsaria

et al. 2011

British Journal of Surgery

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“…[1][2][3][4][5][6][7][8][9][10][11][12] At this time, despite the vast amount of research completed in this area, no unified consensus on the optimal management strategy for penetrating neck injuries exists.…”

Section: Discussionmentioning

confidence: 99%

“…For the remaining patients, management options include mandatory exploration, mandatory imaging, and selective physical examination directed imaging and intervention. [1][2][3][4][5][6][7][8][9][10][11][12] Mandatory exploration of the neck is associated with a high rate of negative exploration with its attendant risks, time, cost and potential for complication. Mandatory screening of all patients with imaging also has its drawbacks.…”

mentioning

confidence: 99%

Prospective Evaluation of Screening Multislice Helical Computed Tomographic Angiography in the Initial Evaluation of Penetrating Neck Injuries

Inaba

Múnera

McKenney

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

126

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“…Using careful clinical examination combined with appropriate diagnostic investigations, the authors stated that approximately 80% of all transcervical gunshots can be treated nonoperatively. Sofianos et al [2], reported a strong preference for conservative management of gunshots, however their study was limited to zone 2 injuries only. In the literature, there have been few reports supporting the use of physical examination solely [16,17,20].…”

Section: Discussionmentioning

confidence: 99%

Is Routine Angiography Necessary in Patients with a Gunshot Wound to the Neck? A Retrospective Analysis

Deurzen

Verleisdonk

2002

Eur J Trauma

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Aim: The aim of this study was to investigate the implication of clinical findings of vascular injury and routinely employing angiography in patients who sustained a gunshot to the neck. Patients and Methods: We retrospectively studied the demographics, bullet tract, clinical findings, diagnostic investigations, methods of treatment, outcome, and time in hospital of 70 patients who sustained a gunshot to the neck and who all underwent angiography. Results: In nine cases angiography revealed lesions to the common carotid artery (four patients), internal carotid artery (three patients), vertebral artery (one patient), and lingual artery (one patient). Physical examination had already indicated vascular damage in seven of these patients with findings such as expanding hematoma (four patients), absent carotid pulsations (two patients), bruit (one patient), and hypovolemic shock (one patient). Subsequently, these seven patients were treated operatively by performing elective neck exploration. Of these seven patients who underwent surgical repair, vascular damage was already suspected based on physical examination. The two patients with injury on angiography without clinical evidence did not deteriorate on conservative management. Conclusions: Careful clinical assessment proves to be a useful instrument in determining the necessity of surgical exploration. In our experience in 70 patients, the results of angiography did not alter the management of the patients who sustained a gunshot to the neck.Our results on conservative management with selective angiography indicate that morbidity and mortality of unnecessary neck explorations are avoided without increased risk.

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Selective surgical management of zone II gunshot injuries of the neck: A prospective study

Cited by 44 publications

References 11 publications

Management of penetrating neck injuries

Management of penetrating neck injuries

Prospective Evaluation of Screening Multislice Helical Computed Tomographic Angiography in the Initial Evaluation of Penetrating Neck Injuries

Is Routine Angiography Necessary in Patients with a Gunshot Wound to the Neck? A Retrospective Analysis

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