Stab wounds of the neck--observations on management

Seventeen stab wounds to the cervical region presenting over a 3 year period are described. Clinical assessment, appropriate investigations and surgical management are discussed. Examination of the oral cavity for the presence of blood or displacement of the lateral oropharyngeal wall by an expanding haematoma, assessment of air bubbling from a wound, particularly on coughing, chest and lower cranial nerve examination are all required. Blind probing or attempted clamping of a bleeding vessel in a neck wound is not recommended. The use of urgent angiography in stab wounds high in the neck behind and above the angle of the mandible is recommended. Primary repair is optimal for all laryngotracheal, pharyngo-oesophageal and significant neurological injuries.