scholarly journals Experiences of Penetrating Neck Injuries in a Single Institution

2020 ◽  
Author(s):  
Dongsub Noh ◽  
Jin Ho Choi
Keyword(s):  
Vital Signs ◽  
Computed Tomographic Angiography ◽  
Neck Injury ◽  
University Hospital ◽  
Neck Injuries ◽  
Computed Tomographic ◽  
Penetrating Neck Injury ◽  
Tomographic Angiography ◽  
Mechanism Of Trauma ◽  
Complications And Mortality

Abstract Background: The neck is a particularly critical region to sustain penetrating injuries, due to the close approximation of the trachea, esophagus, blood vessels, and the spinal cord. A penetrating neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of penetrating neck injuries.Methods: In this retrospective study, penetrating neck injury patients who were admitted to Eulji University Hospital Trauma Center, between December 2015 and December 2017, were analyzed for epidemiology, mechanism of trauma, injured organ, complications, and mortality.Results: Thirty-two patients presented with a penetrating neck injury. All patients underwent computed tomographic angiography to evaluate their injuries once vital signs were stabilized.Among these patients, 27 required surgical treatment. The most commonly injured organ was the trachea. Overall mortality was five, and the main cause of death was bleeding. The mortality was associated with initial systolic blood pressure at the hospital, Glasgow coma scale, transfusion and the abbreviated injury scale of neck.Conclusion: Meticulous clinical examination as well as early volume resuscitation is essential for treating penetrating neck injury patients. Aggressive fluid therapy during transfer to the hospital will help the patient, even if the damage is severe.

Utility of Screening for Blunt Vascular Neck Injuries with Computed Tomographic Angiography

2006 ◽  
Vol 60 (1) ◽  
pp. 209-216 ◽  
Author(s):  
Nathan P Schneidereit ◽  
Richard Simons ◽  
Savvas Nicolaou ◽  
Douglas Graeb ◽  
D Ross Brown ◽  
...  
Keyword(s):  
Computed Tomographic Angiography ◽  
Neck Injuries ◽  
Computed Tomographic ◽  
Tomographic Angiography

Efficiency Assessment of Multidetector-Row Computed Tomographic Angiography Using Reconstruction With Locoregional Perforator Flaps

2021 ◽  
pp. 229255032110247
Author(s):  
Pavlo O. Badiul ◽  
Sergii V. Sliesarenko ◽  
Nataliia O. Cherednychenko ◽  
Olga V. Morgun
Keyword(s):  
Perforator Flap ◽  
Computed Tomographic Angiography ◽  
Surgical Reconstruction ◽  
Patient Treatment ◽  
Controlled Study ◽  
Control Group ◽  
Perforator Flaps ◽  
Multidetector Row ◽  
Computed Tomographic ◽  
Tomographic Angiography

Background: Reconstruction with the use of perforator flaps makes it possible to make the skin surface resistant to the influence of mechanical factors and as similar to the lost skin cover as possible. However, while planning any flap, along with the design of the required shape and size, its blood supply should be taken into account to ensure optimal viability. Therefore, the task to precisely determine the topographic–anatomical relationships suitable for the formation of a pedicle of perforators is still relevant. The aim of this study was to increase the efficiency of surgical reconstruction of wound defects by transposition of locoregional perforator flaps. Methods: The authors conducted a retrospective analysis of 72 cases of reconstruction by means of locoregional perforator flaps with vascular pedicle detachment to determine the efficiency of preoperative diagnostic preparation with the help of multidetector-row computed tomographic angiography (MDCT) in the process of reconstruction. Thirty-seven individual cases of surgical interventions were chosen using a case-controlled study from the study group when MDCT with angiography was used for preoperative planning of perforator flaps, as well as 35 control cases similar in terms of important predictive peculiarities with the reconstruction at the same level of difficulty. The patient groups were precisely matched by gender ( P = .950), age ( P = .804), flap area ( P = .192), and type of reconstruction that was performed. Results: In all cases, the location of the perforator with a diameter greater than 1.0 mm was marked. All perforators determined during MDCT scanning were faultlessly localized intraoperatively. The distance between the intraoperative position of the perforator and the position obtained in the result of the examination did not exceed 1 cm. There was no need to change the planned design of the flap intraoperatively. In all cases where MDCT was performed, the duration of the surgical procedure varied from 60 to 150 minutes (average: 120.77 [18.90] minutes) and was reduced by 49.40 minutes (95% CI: 39.17-59.63) compared with the patients who did not undergo preoperative visualization of perforators where the average duration of the operation was 170.17 (19.19) minutes (from 140 to 220 minutes). Among the patients examined by MDCT, surgical complications were noted in 5 cases (13.51%) compared to 14 cases (40.00%) in the control group. Conclusions: The preoperative MDCT for the locoregional perforator flap reconstruction makes it possible to increase the efficiency of patient treatment given the reduction in surgery duration by 49.40 minutes (95% CI: 39.17-59.63) on average and the reduction in the level of postsurgery complications from 40% to 13.5% compared with the group of patients in whom presurgical visualization was not performed ( P = .031).

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