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Vol. 100. Issue 10.
Pages 629-634 (October 2022)
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Vol. 100. Issue 10.
Pages 629-634 (October 2022)
Original article
5-Year management and outcomes of penetrating neck injury in a trauma center. Penetrating neck injury
Manejo y resultados de trauma penetrante de cuello en 5 años dentro de un centro de urgencias. Trauma penetrante de cuello
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Francisco Reyna-Sepúlvedaa,
Corresponding author
francisco.reynas@uanl.mx

Corresponding author.
, Daniel Cantu-Alejoa, Adrian Martinez-Fernandeza, Jaime Rodriguez-Garciaa,b, Asdrubal Guevara-Charlesa,b, Edelmiro Perez-Rodrigueza, Marco Hernandez-Guedeaa,b, Gerardo Muñoz-Maldonadoa
a General Surgery Department, University Hospital, Universidad Autónoma de Nuevo León, Mexico
b Emergency Department, University Hospital, Universidad Autónoma de Nuevo León, Mexico
Article information
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Abstract
Background

Penetrating neck injuries represent 5–10% of all traumatic injuries, these bring with them a high rate of morbidity and mortality due to vital structures that could be injured in this area. The aim of this study was to determine the epidemiological and clinical characteristics of penetrating neck injuries.

Methods

This was a retrospective, unicentric and descriptive study that included all patients who underwent neck exploration surgery.

Results

A total of 70 neck exploration cases were reviewed, 34 (49%) didn’t had any injury. Thirty (43%) had at least one hard sign, 42 (60%) patients showed at least one soft sign. Statistical analysis showed only surgical time (252±199.5 vs. 155±76.4; p=0.020) and transfusions (1.87±3 vs. 0.4±0.856; p=0.013) were statistically significant. We report a mortality of 2 (3%) patients.

Conclusions

Our prevalence of neck surgical exploration without vascular injury was slightly higher (49% vs. 40%) than literature. We highlight the importance of not performing neck explorations in all patients who present a penetrating injury. We did not obtain differences between groups for hard signs and soft signs. We were not able to identify whether or not there would be an injury based on clinical characteristics. Imaging studies should be performed to avoid unnecessary neck explorations; however, depending on the clinical scenario some surgery cannot be avoided.

Keywords:
Neck
Penetrating
Vascular
Trauma
Surgical time
Resumen
Antecedentes

Las lesiones penetrantes de cuello representan entre el 5-10% de todas las lesiones traumáticas, estas traen consigo una alta tasa de morbimortalidad por estructuras vitales que podrían lesionarse en esta área. El propósito de este estudio fue determinar las características epidemiológicas y clínicas del trauma penetrante de cuello.

Métodos

Estudio retrospectivo, unicéntrico y descriptivo que incluyó a todos los pacientes sometidos a cirugía de exploración de cuello.

Resultados

Se revisaron un total de 70 casos de exploración de cuello, 34 pacientes (49%) no presentaron ninguna lesión. Treinta pacientes (43%) tenían al menos un signo duro, 42 pacientes (60%) mostraron al menos un signo blando. El análisis estadístico mostró que solo el tiempo quirúrgico (252±199,5 vs. 155±76,4; p=0,020) y las transfusiones (1,87±3 vs, 0,4±0,856; p=0,013) fueron estadísticamente significativas. Reportamos la mortalidad de 2 pacientes (3%).

Conclusiones

Nuestra prevalencia de exploración quirúrgica de cuello sin lesión vascular fue ligeramente superior (49 vs. 40%) que la literatura. Destacamos la importancia de no realizar exploraciones de cuello en todos los pacientes que presentan una lesión penetrante. No obtuvimos diferencias entre grupos para signos duros y signos blandos. No pudimos identificar si hubiera o no una lesión en función de las características clínicas. Se deben realizar estudios de imagen para evitar exploraciones innecesarias del cuello; sin embargo, dependiendo del escenario clínico, no se pueden evitar algunas cirugías.

Palabras clave:
Cuello
Penetrante
Vascular
Trauma
Tiempo quirúrgico

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