Penetrating Neck injury: current management in a UK Major Trauma Centre

EM Farrar, A Prasai, TJ  Stansfield*
ENT Department, Leeds Teaching Hospitals NHS Trust, UK
Leeds Vascular Institute*, Leeds Teaching Hospitals NHS Trust, UK

Background:	
Penetrating Neck Injury (PNI) presents uncommonly to UK Major Trauma Centres (MTCs). There is no national guideline. 

Objective:	
To retrospectively analyse a UK MTC experience of PNI presentation, decision making and prognosis.

Method:	
A TARN database interrogation was performed between April 2013 and December 2017  for a North England MTC.  Patient demographics, Injury/operative profile, length of stay (LOS) and mortality were recorded.

Results:	
25 patients with PNI were identified; median Injury Severity Score (ISS)=15.  15 of the 22 patients surviving to the operating theatre had structural neck injuries (vascular, aerodigestive tract, nerve or salivary gland) managed by a combination of specialities.  Aerodigestive tract injuries and ISS>15 were each significant predictors for hospital LOS> two weeks (p<0.01, Chi Squared Test).

Conclusion: 
Injuries are diverse in nature, severity, and associated polytrauma.  Management in this context involves injury prioritisation and a complex specialty care interface, making detailed protocols challenging to establish.