110 bullet wounds to the neck.

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Surgical Outcomes

Background:

• Traditional management of neck bullet wounds often involves mandatory surgical exploration.
• This approach carries risks, including unnecessary surgery and associated complications.
• Selective management strategies aim to optimize patient care and resource utilization.

Purpose of the Study:

• To evaluate the efficacy and safety of selective management for patients with bullet wounds to the neck.
• To assess the impact of selective management on mortality, morbidity, and healthcare costs.
• To identify criteria for patient selection for observation versus exploration.

Main Methods:

• Retrospective analysis of 110 patients with bullet wounds to the neck.
• Patients were managed selectively based on clinical signs, trajectory, and time to presentation.
• Diagnostic tools included radiologic and endoscopic techniques for stable patients without obvious major injury.

Main Results:

• Overall mortality rate was 2.7%, comparable to literature ranges (2-6%).
• 31 patients underwent exploration, while 79 were managed non-operatively (observation).
• Selective management demonstrated cost savings and reduced operative risks.

Conclusions:

• Selective management is a safe and effective strategy for carefully selected patients with neck bullet wounds.
• This approach is feasible in well-resourced institutions with experienced trauma teams and diagnostic capabilities.
• Further research into penetrating neck trauma mechanisms is warranted to refine treatment protocols.