Link of Video Abstract: https://youtu.be/Tk7yWllByJQ
Background: Neck penetrating injuries are a life-threatening emergency. To date, one of the areas of ongoing controversy is whether all penetrating neck wounds in Zone II still require surgical exploration or whether patients can be managed non-operatively. An approach with absolute exploratory management for every penetrating neck wound results in a substantially reduced mortality rate.
Case Description: We presented 5 cases of neck penetrating injury patients. In the first case, a 33-year-old man presented with a neck wound, hoarseness and subcuticular emphysema; the patient underwent colli exploration. In the second case, a 39-year-old man presented with multiple wounds in the neck, hematemesis and subcuticular emphysema; the patient underwent colli exploration. In the third case, a 27-year-old male patient presented with an 8 cm long open wound on the anterior colli, a visible rupture of cricoid and thyroid cartilage; the patient underwent tracheostomy and debridement. In a fourth case, a 37-year-old male patient presented with a 12 cm long sutured wound in the anterior colli, hoarseness, emphysema and air bubbling from the wound; the patient underwent colli exploration. In the fifth case, a 41-year-old male patient presented with a 7 cm long sutured wound at the anterior colli and a defect on thyroid cartilage; the patient underwent colli exploratory surgery.
Conclusion: A hard sign was obtained in all five cases, and immediate colli exploration was performed without diagnostic supportive examination. The decision to perform surgery is now based on the presence or absence of "hard signs" of a penetrating neck wound.