Airway injuries. The first priority in trauma

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Surgical Critical Care

Background:

• Airway injuries, including tracheal, laryngeal, and bronchial, pose significant challenges in trauma care.
• These injuries result from both penetrating (gunshot, stab wounds) and blunt mechanisms (motor vehicle accidents, crush injuries).

Purpose of the Study:

• To describe a protocol for the evaluation and immediate treatment of airway injuries.
• To analyze outcomes and identify key factors in the successful management of these critical injuries.

Main Methods:

• Review of 20 patients treated for airway injuries over 12 years.
• Application of Advanced Trauma Life Support (ATLS) guidelines for evaluation and management.
• Surgical repair techniques including primary closure, tracheostomy, and segmental resection with anastomosis.

Main Results:

• The majority of patients were male (16/20) with an average age of 29.6 years.
• Tracheal injuries were most common (11/20), followed by laryngeal (6/20) and bronchial (2/20).
• 18 of 20 surviving patients recovered fully; mortality was 10% (2/20) due to associated injuries.

Conclusions:

• Aggressive initial management and a high index of suspicion are crucial for airway injury diagnosis.
• Meticulous surgical repair, guided by ATLS principles, leads to high rates of successful recovery.
• Prompt airway stabilization, including intubation or tracheostomy, is vital for patient survival.