The management of penetrating injuries of the anterior triangle of the neck.

The management of penetrating injuries of the anterior triangle of the neck is controversial and poses several problems. A policy of mandatory neck exploration of these injuries is followed in the Department of General Surgery at the State Hospital, Windhoek. A retrospective study of patients presenting to one of the four surgical firms at The State Hospital was performed to see if this policy was justified. Twenty-seven patients were reviewed of which 25 presented acutely and two presented late with severe complications. The clinical and operative findings and the mortality rate of 7 per cent were similar to previous reports. The negative exploration of 30 per cent was less than previous reports of mandatory neck exploration for penetrating trauma. This may have been because exploration was limited to injuries involving the anterior triangle of the neck in this series. All 14 patients with positive clinical findings were found to have injuries at exploration and five of 13 patients (38 per cent) with no clinical signs were found to have injuries. Given these results and in the setting of The State Hospital it was felt that the policy of mandatory exploration was justified.