Selective surgical management of zone II gunshot injuries of the neck: a prospective study.
BACKGROUND
The management of penetrating neck trauma remains controversial, with many studies supporting either mandatory exploration or selective conservatism.


RESULTS
This is a prospective study of 75 patients with gunshot injuries to zone II of the neck. Forty patients (53.3%) underwent immediate exploration because of clinical indications or positive initial investigations. A 7.5% incidence of unnecessary explorations, a 5% mortality rate, and average hospital stay of 10.5 days were noted. Thirty-five patients with negative clinical or investigational findings underwent observation with constant monitoring. A 5.7% incidence of missed injuries, no mortality, and an average hospital stay of 3.5 days were noted for these patients.


CONCLUSIONS
We suggest that conservative management in gunshot injuries confined to zone II of the neck selectively supplemented by appropriate investigations is a viable proposition in this type of injury. Further contemporary studies reporting specifically on this injury will enable us to reach statistically significant conclusions.
Sofianos
C
C
Department of Surgery, Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, Republic of South Africa.
Degiannis
E
E
Van den Aardweg
M S
MS
Levy
R D
RD
Naidu
M
M
Saadia
R
R
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D019838:Neck Injuries; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D012449:Safety; D013019:South Africa / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000401:mortality / Q000601:surgery*