Management of penetrating wounds of the neck

Cricohyoidoepiglottopexy in an emergency scenario: Evaluation and management of a severe laryngeal trauma

We describe the clinical evaluation and the management of a severe laryngeal trauma in a suicidal patient. We aim to demonstrate how the cricohyoidoepiglottopexy, which is a surgical technique mainly performed for oncological purposes, can be successfully used in this emergency setting.

Diagnosis, management and treatment of neck trauma

Trauma injuries to the neck account for 5-10% of all trauma injuries and carry a high rate of morbidity and mortality, as several vital structures can be damaged. Currently, there are several treatment approaches based on initial management by zones, initial management not based on zones and conservative management of selected patients. The objective of this systematic review is to describe the management of neck trauma.

Penetrating neck injury: a case report and review of management

Penetrating neck injury constitutes 5-10 % of all cases seen in the emergency room. As surgeons we must be prepared to manage these cases. After stabilizing the general condition of the patient the neck injuries are assessed. Management has changed from routine exploration to selective exploration. Injury to aerodigestive tract and vessels are commonly seen.

[Impalement injury of the neck]

In comparison to the United States or South Africa, penetrating injuries of the neck are rare in Europe. Most of these traumas are due to sharp perforation mechanisms. We report on a 43-year-old man who was admitted to the emergency room because of an impressive transcervical penetrating neck trauma inflicted by a chisel. He survived the trauma since the chisel missed all important structures of the neck. The diagnostic strategy to evaluate the dimension of the trauma was primarily based on endoscopic and surgical exploration.

155 vascular injuries: a retrospective study in Kuwait, 1992-2000

OBJECTIVES

To audit the management of vascular trauma in Kuwait, 1992-2000.

DESIGN

Retrospective open study.

SETTING

Vascular surgery unit, teaching hospital, Kuwait.

SUBJECTS

155 patients with vascular injuries, most of which (n = 118) involved the extremities. 21 had neck injuries, 10 abdominal, and 6 chest.

INTERVENTION

Revascularisation usually using the long saphenous vein in addition to direct repair or end-to-end anastomosis.

MAIN OUTCOME

Morbidity (amputation) and mortality.

RESULTS

Four lower limb grafts failed, two of which (2/69, 3%) required amputation. Overall, four patients died (3%), one of pulmonary embolism and 3 of severe injuries to major abdominal vessels. 3/10 patients with abdominal vascular trauma died. Mean (SD) follow up period was 4.4 (2) years.

CONCLUSIONS

Civilian violence has increased in Kuwait. Vascular trauma to abdominal vessels is associated with high mortality. Autogenous saphenous vein forms an excellent conduit for revascularisation.