RESUMEN
BACKGROUND: Selective non-operative management (SNOM) is the current gold standard for the treatment of patients with penetrating neck trauma. The policy revolves around the liberal use of computed tomography angiography (CTA) in those patients who are haemodynamically stable, irrespective of the anatomical zone of injury, aiming at reducing the incidence of negative and non-therapeutic interventions and their potential complications. METHODS: A retrospective audit of results of patients who underwent immediate surgical exploration at the Chris Hani Baragwanath Academic Hospital in Soweto between January 2010 and December 2015 was performed. RESULTS: One-hundred and forty-five (145) patients, with a median age of 28 years (range 18-67 years), predominantly males (93.8%), underwent immediate exploration. Most injuries were caused by stab wounds (92.4%) and affected zone 2 (54.1%) on the left side of the neck (69.6%). The most common presentations were active haemorrhage (29.4%), shock (24.1%) and expanding haematoma (15.1%). A major vascular injury was found in 40%, and aero-digestive organ injury in 19.3%. The rate of negative-non-therapeutic exploration in this cohort was 4.1%. Complications were recorded in 7.6%, and the overall mortality was 9.6% secondary to early uncontrolled haemorrhage, sepsis and occlusive strokes. CONCLUSIONS: The utilisation of SNOM with strict criteria for selection of patients who require immediate surgical exploration versus investigations with CTA results in a low rate of non-therapeutic interventions.
Asunto(s)
Traumatismos del Cuello , Lesiones del Sistema Vascular , Heridas Penetrantes , Heridas Punzantes , Masculino , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Femenino , Estudios Retrospectivos , Sudáfrica/epidemiología , Traumatismos del Cuello/diagnóstico por imagen , Traumatismos del Cuello/cirugía , Traumatismos del Cuello/epidemiología , Heridas Penetrantes/diagnóstico por imagen , Heridas Penetrantes/cirugía , Heridas Punzantes/diagnóstico por imagen , Heridas Punzantes/cirugía , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/cirugía , HemorragiaRESUMEN
Penetrating abdominal trauma (PAT) is seen daily in our trauma ward. We present a retrospective study of the patients managed in our hospital (Polokwane Hospital; Limpopo) from January 1999 to March 2000. Epidemiology; mechanism of injury; patterns of injury; management; morbidity and overall mortality were recorded for analysis. Morbidity and mortality were commonly associated with peritonitis and multiple organ dysfunction syndrome
Asunto(s)
Dolor Abdominal , Heridas y Lesiones/cirugíaRESUMEN
Penetrating abdominal trauma (PAT) is seen daily in our trauma ward. We present a retrospective study of the patients managed in our hospital (Polokwane Hospital, Limpopo) from January 1999 to March 2000. Epidemiology, mechanism of injury, patterns of injury, management, morbidity and overall mortality were recorded for analysis. Morbidity and mortality were commonly associated with peritonitis and multiple organ dysfunction syndrome.