Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXVII: Wounds and Injuries of the Neck

Introduction

United States Department of Defense

Wounds of the neck, because of the large number of vital structures within a compact area, are frequently complicated injuries which demand prompt surgical care. A single wound may damage multiple systems, involving the larynx, trachea, pharynx, esophagus, major vessels, multiple nerves, the spinal cord, and the cervical spine. Asphyxia and severe hemorrhage commonly occur. Pharyngeal and esophageal wounds that communicate with the mediastinum via the fascial planes of the neck may result in bacterial contamination of the mediastinum and subsequent mediastinitis. Foreign bodies carried through these soft tissues may cause further contamination. Small injuries to the skin and fascia may be associated with more severe injuries of deeper structures. Neck wounds are often associated with oral and intrathoracic injuries. These injuries may initially be occult but will demand attention. The hallmarks of good management of neck wounds are adequate incisions, generous exposure, and careful debridement followed by wide drainage. Antibiotics should be given to all patients with deep neck wounds.

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Operational Medicine 2001

Health Care in Military Settings

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