Penetrating Neck Trauma

Kendall, John L.; Anglin, Deirdre; Demetriades, D.

doi:10.1016/s0733-8627(05)70350-3

Cited by 94 publications

(53 citation statements)

References 43 publications

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“…Major vascular injury occurred in 11% of surviving patients which constituted a nearly 3.5-fold greater incidence than direct CSCI. Prior studies reported major vascular injury complicating over 25% of penetrating cervical trauma [1,[7][8][9]17]. The source of discrepancy between the incidence of major vascular injury in this study and other reported studies was not clear but may represent statistical variance.…”

Section: Discussioncontrasting

confidence: 59%

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Cervical spine immobilization in penetrating cervical trauma is associated with an increased risk of indirect central neurological injury

Turnock¹,

Carney²,

Fleischer³

et al. 2016

Trauma Emerg Care

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This study hypothesized that cervical spine immobilization (CSI) in penetrating cervical trauma is associated with increased central neurologic injury rather than prevention. Data abstraction proceeded from a previously constructed patient database formed via retrospective chart analysis of the trauma registries of two independent American College of Surgeons verified Level 1 Trauma centers. Neurologic injuries were categorized as peripheral or central. Central neurologic injuries were further subdivided into spinal cord and brain injuries. Patients were grouped according to the presence and type of neurologic injury, the presence and type of cervical spine fracture, death, and the presence or absence of respiratory and vascular injury. Vascular injury was further subdivided into major and minor categories. Groups were compared statistically. Significance was accepted for p<0.05. Cervical spine fracture (CSFx) was a significant risk factor for cervical spinal cord injury (CSCI) (p<0.00001; RR 20.56; 95% CI 8.44-26.47) but all patients with unstable CSFx presented with complete spinal neurologic devastation. Major vascular injury was associated with brain injury (p=0.01; RR 10.21; 95% CI 6.67-15.65) but was not associated with CSCI (p=0.99) or CSFx (p=0.67). Hypoperfusion was a strong independent risk cervical cord and brain injury (p<0.00001; RR 38.4; 95% CI 16.17-91.2). CSI was a significant risk factor for indirect central neurologic injury (p<0.001; RR 1.63; 95% CI 1.23-1.95). Brain injury was not associated with CSFx (p=0.35) or CSCI (p=0.08). No benefit of CSI in penetrating cervical trauma could be determined from this study. CSI entailed an absolute risk increase for central neurologic injury of 18.69% with a 5.3 number needed to harm (NNH).

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Section: Discussioncontrasting

confidence: 59%

“…The rapid mortality associated with vascular and airway injuries emphasizes the importance of immediately treating these lifethreatening injuries before addressing concerns about cervical spine instability [5,[17][18][19][20][21][22]. Transport delays for CSI vary from an average of 8-30 mins [23,24].…”

Section: Introductionmentioning

confidence: 99%

Cervical spine immobilization in penetrating cervical trauma is associated with an increased risk of indirect central neurological injury

Turnock¹,

Carney²,

Fleischer³

et al. 2016

Trauma Emerg Care

View full text Add to dashboard Cite

show abstract

“…3 Neck trauma accounts for 5-10% of all serious traumatic injuries. (4) In our series most of the patients belong to age group 20 to 45 years (n=26, 76.47%) with male to female ratio 10.33: 1 (Table 1).Other series have also reported a predominance of males, ranging from 71 to 91%, and mean ages ranging from 25 to 34.5 years (5,6,7,8) . This finding reveals that male in active phase of life are more prone for such injuries.…”

Section: Discussionsupporting

confidence: 51%

Surgical Management of Life Threatening Penetrating Neck Injuries – A Single Handed Experience

Naithani¹,

Sharma²

2013

jemds

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AIMS AND OBJECTIVE:To evaluate demographics, management and outcome of life threatening penetrating neck injuries (PNI). MATERIAL AND METHOD: A total of thirty four patients of severe PNI were referred to us between August 2003 and Feb.2013. Simple emergency investigations like hemogram and X rays or in few cases CT scan were enough to decide emergency exploration. Patients who were in shock required resuscitation. RESULT: Out of 34 patients, males in active phase of life (24 patients, 70.59%) predominate. Road traffic accident (RTA) (11 Patients, 32.35%), bullet injuries (10 patients, 29.41%) and sharp object (11 patients, 32.35%) were most common cause of injuries. Homicidal injuries predominates .Bleeding was the most common presentation seen in all cases from neck vessels. Aero digestive, neurological, lung and pleura involvement were other injuries encountered. Patients have maximum injuries at Zone I region (19 patients, 55.88%) and managed by supraclavicular approach (16 patients, 47.06%).We had 1 (2.94%) mortality. CONCLUSION: Emergency surgical exploration and ICU management saved life of most of life threatening PNI .We recommend time should not be delayed in detail diagnosis and evaluation of such injuries.

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“…et al suggested that pharyngeal, hypopharyngealand laryngeal mucosal lacerations should ideally be repaired early (within 24 hours), [3][4][5] .…”

Section: Cut Throat Injuries At a Tertiary Referral Hospital In Guwahmentioning

confidence: 99%

“…Cut throat injuries causes profound morbidity due to prolonged hospitalization, high cost of health care, loss of productivity and reduced quality of life and above all death, [1,2] .Globally cut throat injuries account for approximately 5% to 10% of all traumatic injuries with multiple structures being injured in 30% of patients, [3][4][5][6][7] .Cut throat injuries pose a great challenge because multiple vital organs for phonation, deglutition, vascular and neurological structures vulnerable to injuries are present in the small, confined unprotected area. A sudden increase in the number of admissions of patients with cut throat injuries in our setting prompted the authors to analyse this problem.…”

Section: Introductionmentioning

confidence: 99%

Cut throat injuries at a tertiary referral hospital in guwahati: a review of 165 cases

De¹,

Sarma²

2016

IOSR

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Penetrating Neck Trauma

Cited by 94 publications

References 43 publications

Cervical spine immobilization in penetrating cervical trauma is associated with an increased risk of indirect central neurological injury

Cervical spine immobilization in penetrating cervical trauma is associated with an increased risk of indirect central neurological injury

Surgical Management of Life Threatening Penetrating Neck Injuries – A Single Handed Experience

Cut throat injuries at a tertiary referral hospital in guwahati: a review of 165 cases

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