Management of penetrating zone II neck injuries

The evolving management of penetrating neck injuries.

The management of penetrating neck injuries has changed tremendously in the last 20 years. During the 1960s and 1970s the golden rule for such injuries was mandatory neck exploration. This policy became generally accepted because of the anatomical proximity of the neck to important structures, the potential of disastrous consequences, and previous military experience. However, experience in the...

Clinical practice guideline: penetrating zone II neck trauma.

STATEMENT OF THE PROBLEM Penetrating wounds of the neck are common in the civilian trauma population. Risk of significant injury to vital structures in the neck is dependent on the penetrating object. For gunshot wounds, approximately 50% (higher with high velocity weapons) of victims have significant injuries, whereas this risk may be only 10% to 20% with stab wounds. The management of injurie...

Penetrating abdominal injuries: management controversies

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a m...

Penetrating neck injury from a screwdriver: can the No Zone approach be applied to Zone I injuries?

The newer approach to management of penetrating neck injuries (PNI) involves the No Zone approach: comprehensive physical examination combined with CT angiography for triage to effectively identify or exclude vascular and aerodigestive injury. This approach, however, has a low negative exploration rate; there is risk of missing occult injuries especially Zone I and III PNI. We report a case of ...

Penetrating Injuries to the Abdomen - I & II