Clinical experience in the management of penetrating stab wounds to the neck: A retrospective analysis of 5 cases.

PURPOSE: Penetrating neck trauma can frequently be life-threatening, including those that appear minor. Consequently, thorough examination and quick operative treatment have been the standard measure. In addition, modern precision medicine has shifted the procedure towards more selective non-operative management, whereas advanced imaging like computed tomography angiography plays a key role. The diagnostic and therapeutic protocol remains to be adapted and optimized. The purpose of this study was to present our experience, outcomes, and management strategy, and contribute to establishing an evidence-based algorithm for stab wounds to the neck area.

METHODS

This was a retrospective, observational cohort study conducted at 3 hospitals involving 5 patients with stab wounds to the neck between Jan, 2013 and Dec, 2023. Preoperative interventions included airway and circulation restoration. Ancillary investigations, including imaging and electronic laryngoscopy, were used to assess potential vascular, nerve, and cervical vertebra injury. Surgeries included exploration, debridement, and closure under general anesthesia, with blood transfusion when necessary. Patients were followed up for recovery status and provided postoperative management.

RESULTS

Among the 5 patients aged 21-64 years, 4 were males and 1 was female. All wounds were located on the lateral aspect of the neck. Four patients had pharyngocutaneous fistulas with hematemesis/hemoptysis, and 3 of them experienced hemorrhagic shock. One patient had nerve damage, and 1 patient had an airway compressed. All patients underwent successful surgery. Patients were followed up for more than 6 months, and examinations revealed good wound healing, partial recovery of facial nerve function, and no other residual functional impairments in any of the 5 patients.

CONCLUSION

Adequate preoperative preparation and assessment, timely and effective exploratory surgery, efficient multidisciplinary cooperation, and comprehensive postoperative management can maximize the chances of life-saving and functional recovery for penetrating stab wounds in the neck area.