Penetrating neck wounds

Over a 15 year period 120 patients with neck injuries that penetrated the platysma were studied. Appropriate treatment was initiated in the emergency room. Sixty-one patients underwent exploration and 59 were observed. Two of the observed patients later required delayed operation. In 9.2 percent of the patients, two or more injuries were present within the neck, whereas in 30 percent the neck injury was only one of many bodily injuries. Length of hospital stay for the operative group of patients was 9 days and for the nonoperative group 5 days. There was one death. The complication rates in the operative and nonoperative groups were 2.5 and 1.7 percent, respectively. The major structures injured were within the venous system. The neck injuries were classified according to three zones defined by Saletta and Jones and their co-workers [4,5]. The majority were Zone II injuries. Our morbidity and mortality rates are slightly lower than those reported in most series. This review supports the concept that therapy for penetrating injuries to the neck should be individualized.