Penetrating injuries to the head and neck

ABSTRACT

A review of the incidence of penetrating injuries to the head and neck in Jamaica reveals an increase of almost 100 percent from 1974 to 1987 from a average of 57 cases per year in 1974 to 135 cases per year in 1997. In the USA from 1967 to 1983 (16 years) the increase was 48 percent with a projected 2 percent annual increase for industrialised cities for example 1. In 1975 there were 112 stab wounds and 98 gun shot wounds to the head and neck. 2. In 1976 there were 118 stab wounds and 121 gun shot wounds to the head and and neck. Penetrating injuries from firearms have risen steadily in Jamaica to equal those from stab wounds and this due to increase in the use of illegal weapons; for example 1. In 1974 there were 17 stab wounds and 6 gun shot wounds to the head and neck. 2. In 1997 there were 27 stab wounds and 24 gun shot wounds to the head and neck. The typical victim of this injury is a male in his late teens to twenties and the left side of his head and neck is the most common site of injury. The type of object or weapon which inflicts the injury also affects the severity of the injury. Stab wounds cause fewer severe injuries than a machete chop, but with the introduction of firearms with muzzle velocities in the region of 760 metres per second, injury to both sides of the head and neck is possible with one missile. Management in Jamaica is based on selective exploration of these injuries. Our mortality rate of patients who reach the operating table alive does not exceed 1 percent.(AU)