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[Bleeding control in stab wounds to the great vessels at the neck base]
C Moroşanu1, S Lunca, S N Romedeă
1Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Spitalul de Urgente Iaşi, Clinica Urgenţe Chirurgicale.
Abstract:
Stab wounds of the neck are a great challenge for every surgeon. Approximately 25% of penetrating neck injuries results in a vascular lesion. Wounds being situated below the cricoid cartilage are associated with the great mortality and morbidity, having a global mortality between 12-20%. 2/3 of the vascular wounds at this level have a tragic end. We are going to present 3 cases of cervical stab wounds in zone 1 of the neck, with vascular lesions, in which we succeeded to control the hemorrhages throw a midline sternotomy combined with different extensions. After this small experience we think that in patients with wounds situated in zone 1 of the neck, who reach the hospital hemodynamically unstable or with active bleeding, urgent midline sternotomy combined with cervicotomy, or section of the clavicle, is the best way to control the hemorrhages. Using blunt digital dissection we can avoid unpleasant situations that can appear using instrumental dissection into the mediastinal hematoma.
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