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Titolo:
Penetrating neck injuries: analysis of experience from a Canadian trauma centre
Autore:
Nason, RW; Assuras, GN; Gray, PR; Lipschitz, J; Burns, CM;
Indirizzi:
Univ Manitoba, Dept Surg, Trauma & Acute Care Serv, Winnipeg, MB, Canada Univ Manitoba Winnipeg MB Canada & Acute Care Serv, Winnipeg, MB, Canada
Titolo Testata:
CANADIAN JOURNAL OF SURGERY
fascicolo: 2, volume: 44, anno: 2001,
pagine: 122 - 126
SICI:
0008-428X(200104)44:2<122:PNIAOE>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
MANDATORY EXPLORATION; PHYSICAL-EXAMINATION; CONSERVATIVE MANAGEMENT; SELECTIVE MANAGEMENT; VASCULAR INJURIES; WOUNDS; ANGIOGRAPHY; POLICY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Nason, RW Ctr Hlth Sci, Dept Surg, 820 Sherbrook St, Winnipeg, MB R3A 1R9,Canada Ctr Hlth Sci 820 Sherbrook St Winnipeg MB Canada R3A 1R9 Canada
Citazione:
R.W. Nason et al., "Penetrating neck injuries: analysis of experience from a Canadian trauma centre", CAN J SURG, 44(2), 2001, pp. 122-126

Abstract

Objective: To study the demographics and treatment outcome of penetrating neck injuries presenting to a major trauma centre in order to develop a treatment protocol. Design: A case review. Setting: A trauma centre at a tertian care institution. Patients: One hundred and thirty consecutive patients who had 134 neck wounds penetrating the platysma and presented to the trauma service between 1979 and 1997. Intervention: Surgical exploration or observation alone. Main outcome measures: The location of injury, patient management, number of significant injuries, duration of hospital stay and outcome. Results: Injuries were caused by stab wounds in 124 patients (95%) and gunshot wounds in 6 (5%). The location of injury was zone I (lower neck) in 20 cases (15%), zone II (midportion of the neck) in 108 (81%) and zone III (upper neck) in 5 (4%). The location was not recorded in 1 case. Fifty: patients were managed by observation alone and 80 were managed surgically. Neck exploration in 48 asymptomatic patients was negative in 32 (67%). Significant injuries, including major vascular (12), nerve (13) and aerodigestive tract (19) injuries, were identified in 34 patients. Two of the 130 patients (1.5%) died of major vascular injuries. Seventy-six percent of significant injuries, including all zone II major vascular injuries, were symptomaticon presentation. The mean (and standard deviation) hospital stay for asymptomatic patients treated with observation alone and surgical exploration was similar (3.5 [6.02] versus 4.3 [5.46] days respectively, p = 0.575). Long-term disability, all neurologic in nature, was documented in 3 patients managed by observation alone and 6 patients managed by surgical exploration. Conclusions: penetrating neck trauma, in particular stab wounds to zone II in asymptomatic patients, is associated with low morbidity and mortality. Aselective management protocol with investigations directed by symptoms is the most appropriate approach for the patient population and resource base in this setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 16:54:41