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May 1984

Selective Management of Penetrating Neck Injuries: A Prospective Study

Author Affiliations

From the Department of Surgery, University of Colorado Health Sciences Center, Denver (Drs Narrod and Moore), and the Department of Surgery, Denver General Hospital (Dr Moore).

Arch Surg. 1984;119(5):574-578. doi:10.1001/archsurg.1984.01390170070014

• We assessed the feasibility of a selective policy for operative exploration of penetrating neck wounds. Patients with bleeding, hematomas, crepitations, dysphagia, dysphonia, or impaired mental status rendering their conditions nonevaluative had prompt explorations. All other patients were observed in the hospital. Of the 77 patients in this study, 48 (62%) underwent neck exploration based on the preceding criteria; (85%) had major injuries. Of the 29 patients observed according to protocol, none required subsequent exploration for a missed lesion. Ancillary diagnostic procedures in the observed patients consisted of arteriography in four, esophageal contrast studies in five, esophagoscopy in two, and laryngoscopy in one. The average hospital stay for observation was 1.8 days. Our experience confirms the safety and cost-effectiveness of selective exploration for penetrating neck injuries. Moreover, observation does not mandate extensive ancillary testing for level II and III injuries

(Arch Surg 1984;119:574-578)

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