The type of incision depends on the injured zone and structures at risk of injury. At a trauma center with experienced staff, the frequency of negative exploration for PNTs can be minimized by the selective neck exploration. As the accuracy of CTA in the diagnosis of critical structural damage increases, the choice of the clinical decision, especially the decision of the surgical exploration is getting easier. Comprehensive physical examination with CTA is adequate for identifying and excluding vascular and aerodigestive injuries after PNTs. CTA has replaced angiography as the initial study of choice in the vascular evaluation of neck injuries. Physical examination findings supplemented by CTA should have a prominent role in the selective management of PNTs. reports that the use of CTA is associated with fewer operative explorations, fewer negative explorations, and reduced use of invasive studies, such as conventional angiography. Key Words: Wounds, penetrating Neck injuriesĬomputed tomographic angiography (CTA) is generally considered the initial diagnostic method to evaluate the injured organs in PNTs. Although a variety of options are available for the management of PNT, physicians should try to find the best way to treat these injuries. While surgical intervention is necessary in approximately 15%–20% of PNT, the management of stable patients remains a source of debate. PNT, defined by platysma violation, comprises a sizable number of traumatic injuries in adults and remains a difficult management issue. Therefore the concept of selective surgical management which offers a spectrum of diagnostic approaches came from this observation. Although the low mortality rate became obvious, the rate of negative surgical explorations was unacceptably high. This approach resulted in reduced mortality rates. A mandatory surgical approach was adopted in an attempt to reduce the high death rates associated with PNTs and remained widely accepted well into the 1990s. Before World War II, all PNTs were treated conservatively and mortality rate was as high as 35%. Penetrating neck trauma (PNT) refers to neck injuries induced by gunshot wounds, stab wounds, or impaling objects, such as glass or sharp debris.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |