Penetrating wounds of the neck: explore or not?

While routine formal exploration for all neck wounds penetrating the platysma remains a safe policy, our experience indicates that it is not necessarily the best policy in large, well-staffed teaching hospitals with extensive trauma services. Careful and repeated physical examinations and observations supplemented by simple radiograph examinations allowed selection of a large group of patients who were satisfactorily treated by simple wound closure and clinical observations. Aggressive emergency room management and adequate exposure and repair of vascular injuries prevented cerebral damage so common in previous reports.