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Selective surgical management of zone II gunshot injuries of the neck: a prospective study
C Sofianos1, E Degiannis, M S Van den Aardweg
1Department of Surgery, Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, Republic of South Africa.
Background:
The management of penetrating neck trauma remains controversial, with many studies supporting either mandatory exploration or selective conservatism.
Methods And Results:
This is a prospective study of 75 patients with gunshot injuries to zone II of the neck. Forty patients (53.3%) underwent immediate exploration because of clinical indications or positive initial investigations. A 7.5% incidence of unnecessary explorations, a 5% mortality rate, and average hospital stay of 10.5 days were noted. Thirty-five patients with negative clinical or investigational findings underwent observation with constant monitoring. A 5.7% incidence of missed injuries, no mortality, and an average hospital stay of 3.5 days were noted for these patients.
Conclusions:
We suggest that conservative management in gunshot injuries confined to zone II of the neck selectively supplemented by appropriate investigations is a viable proposition in this type of injury. Further contemporary studies reporting specifically on this injury will enable us to reach statistically significant conclusions.