NO ZONE APPROACH FOR MANAGEMENT OF PENETRATING NECK INJURIES-A CASE SERIES

Purpose: The assessment and management of penetrating trauma to the neck has traditionally centered on the anatomical zone based classication over the previous four decades has evolved considerably towards "NO ZONE APPROACH" a more selective option. The purpose of this study was to assess the effectiveness of the “NO ZONE APPROACH” in penetrating neck injuries. Case series of 6 patients with penetrating neck Materials And Methods: injuries admitted in department of general surgery in government Kilpauk medical college and government Royapettah hospital, Chennai. All 6 cases have been analyzed for this descriptive study during a period of 1 year. No specic exclusion criteria applied. All 6 patients survived. 1 patient had nerve injury and external carotid artery injury. 2 patients had Results: tracheal injuries for which tracheostomy was done. 1 patient had avulsed a part of thyroid gland. 1 patient developed cerebrovascular accident post operatively.3 patients had primary repair& neck exploration avoided in those 3 patients by application of NO ZONE APPROACH. Penetrating neck injuries are complex injuries with no single denitive Conclusion: approach. Surgical intervention is mandatory for unstable patients but rapid swift clinical and logical reasoning helps in determining the outcome of the patient. The 'no zone approach' to penetrating neck trauma is a selective approach with superior patient outcomes in comparison with traditional method of zones of neck injuries in which zone 2 and zone 3 warrants denitive exploration. No zone approach mandates thorough clinical examination. Penetrating neck injuries classied as having hard signs based on the no zone approach may be correlated with internal organ injuries of the neck.

Ventricular Septal Defects With Near Systemic Pulmonary Pressures -AN Institutional Experience

Ventricular Septal Defects (VSD) with severe pulmonary hypertension (PHT) patients are the difficult ones to intervene as they carry increased risk of postoperative morbidity and mortality especially when pulmonary pressures are near to systemic pressures.We share our experience of 31 such cases managed by double flap technique and use of pulmonary vasodilators.