Foley catheter balloon tamponade for life-threatening hemorrhage in penetrating neck trauma.
BACKGROUND
Foley catheter (FC) balloon tamponade is a well-recognized technique employed to arrest hemorrhage from penetrating wounds. The aim of this study was to review our experience with this technique in penetrating neck wounds and to propose a management algorithm for patients with successful FC tamponade.


METHODS
A retrospective chart review (July 2004-June 2005 inclusive) was performed of patients identified from a prospectively collected penetrating neck injury computer database in whom FC balloon tamponade was used. The units' policy for penetrating neck injuries is one of selective nonoperative management. All patients with successful FC tamponade underwent angiography. A venous injury was diagnosed if angiography was normal. Ancillary tests were performed as indicated. Removal of the FC was performed in the OR.


RESULTS
During the study period, 220 patients with penetrating neck injuries were admitted to our unit. Foley catheter balloon tamponade was used in 18 patients and was successful in 17 patients. Angiography was positive in 3 patients, all of whom underwent surgery. The FC was successfully removed in 13 patients at a mean of 72 (range 48-96) hours. One patient bled after removal of the catheter, mandating emergency surgery.


CONCLUSIONS
Foley catheter balloon tamponade remains a useful adjunct in the management of selective patients with penetrating, bleeding neck wounds.
Navsaria
Pradeep
P
Trauma Unit, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. navsaria@uctgsh1.uct.ac.za
Thoma
Maximilien
M
Nicol
Andrew
A
D000328:Adult; D000465:Algorithms; D000792:Angiography; D021721:Balloon Occlusion; D002404:Catheterization / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000628:therapy*