Validating the selective management of penetrating neck wounds

In a 12-year period, 188 patients with penetrating wounds to the anterior neck were managed selectively. The 69 symptomatic patients were explored promptly. The remaining 119 patients (63%) were observed in the hospital using ancillary diagnostic tests based on injury location and trajectory. In the explored group, significant injuries were found in 60 patients (87%). In the observed group, one patient (0.8%) required delayed exploration for an occult injury. Average hospital stay for patients after neck exploration was 8.4 days, for patients after negative exploration 4.2 days, and for patients after observation 1.7 days. This ongoing experience confirms the efficacy and safety of selective neck exploration in a Level I Trauma Center.