Selective management of penetrating neck trauma

Of 110 patients with penetrating injuries of the neck, 58 were selectively observed and 52 underwent prompt surgical exploration according to defined criteria. In the group initially selected for observation, none required subsequent surgical intervention, and there was no mortality. Among those patients operated upon primarily, the negative exploration rate was 17 percent, and two patients died, both as a result of their injuries (mortality rate, 4%). We conclude that selective management of patients with penetrating neck injuries, when guided by repeated and careful examinations, is appropriate, does not increase the risk to patients, and avoids unnecessary surgical procedures.