Mandatory exploration in the management of penetrating neck trauma

ABSTRACT

A retrospective analysis of 16 cases of penetrating trauma to the neck admitted in a surgical unit of a teaching hospital, is done to determine the role of mandatory exploration in penetrating trauma and to define measures that improve the outcome. Nine cases had zone I injury and five cases had Zone II injury and all of them underwent exploration. Two cases had Zone III injury and were successfully managed conservatively. There is a negative exploration rate of 7%, and a mortality rate of 6.1%. In all cases who had neck exploration vascular injury was present in all three cases who presented with shock. Laryngotracheal injury was the commonest visceral injury whereas, surgical emphysema was present in 25% of the cases followed by infection of chest and the tracheostomy site [6.1%]. Haemodynamically stable patients with Zone III injury can be managed conservatively but definite exploration should be done in all Zone II injury