Scientific paperValidating the selective management of penetrating neck wounds☆
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Cited by (42)
Penetrating neck injuries
2023, Current Therapy of Trauma and Surgical Critical CareDiagnosis, management and treatment of neck trauma
2019, Cirugia EspanolaRadiographically occult perforation and dissection of the common carotid artery following stab injury to the neck
2017, Trauma Case ReportsCitation Excerpt :Aside from injuries to the aerodigestive tract, PNI frequently involve damage to vascular structures such as the carotid arteries [2]. Aiming to provide improved criteria correlating with injury severity and to reduce the rate of unwarranted surgical explorations, recent studies have advocated a so-called “no-zone” approach to PNI; instead of basing decisions primarily on the location of the external injury (as in a “zone-based approach”), this strategy involves a stepwise diagnostic work-up dependent on patient symptoms, physical findings and adjunct studies [3,4]. CT angiography has been shown to constitute a valuable and readily available tool to guide decision-making in cases where a lack of “hard” symptoms obviates immediate surgical exploration [5,6].
Selective management of penetrating neck injuries using "no zone" approach
2015, InjuryCitation Excerpt :Early experiences of selective management of PNIs have come from the use of “zone-based” algorithms, suggesting mandatory exploration in stable symptomatic zone II injury patients and routine radiographic vascular studies in stable zone I and III injury patients; which yielded 63–66% successful NOM rate [6–8]. Nevertheless, there are problems associated with the zone-based approach including (1) high negative exploration rates in stable zone II injuries (13–19%) [6,7], and (2) poor correlation between the location of neck wounds and internal organ injuries [9]. Furthermore, patients with multiple or transcervical injuries occasionally cannot be grouped into one zone, as seen in 6% of patients in the present study.
Hybrid stent-graft repair of an iatrogenic complex proximal right common carotid artery injury
2012, Annals of Vascular SurgeryCitation Excerpt :Zone III, above the angle of the mandible, is treated as a head injury. Zone II injuries, between zones I and III, are treated with selective surgical exploration.29 Patients who are in profound shock, those exsanguinating from the neck injury, and those in an evolving stroke require immediate exploration.
Penetrating Neck Injuries
2008, Oral and Maxillofacial Surgery Clinics of North AmericaCitation Excerpt :The type of projectile often largely depends on the situation in which it is used, and differs in civilian populations compared with military combat. Civilian wounds typically result from low-velocity, small caliber handguns, stab wounds, various projectiles during motor vehicle collisions, or more unusually, from shotguns or rifles during hunting accidents [23–43]. Military wounds, on the other hand, are caused by missiles moving at a wide range of velocities with a high incidence of injuries caused by booby traps, land-mines, mortar, artillery, or rocket explosions.
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Presented at the 43rd Annual Meeting of the Southwestern Surgical Congress, Las Vegas, Nevada, April 21–24, 1991.
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From the Department of Surgery, Denver General Hospital, and the Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado.