Selective surgical management of penetrating neck trauma. 15-year experience in a community hospital.

The management of penetrating neck trauma continues to generate disagreement in the surgical literature. Current publications of the subject advocate selective surgical intervention only if facilities and manpower are adequate. This review of a 15-year experience in the setting of a community hospital shows unquestionably that if surgeons with clinical experience evaluate this type of trauma, more than 50 per cent of patients are spared necessary operations. On the other hand, if patients are selected to undergo surgery because of strong clinical indications and the decision is carried out promptly, unnecessary and costly diagnostic studies are avoided. By following this policy of selective surgical management, our mortality rate of 3 per cent compares favorably with reports in the literature. No increased morbidity was noted in those patients managed nonoperatively.