Criteria of Klyachkin et al for Mandatory Neck Exploration Following a Penetrating Injury of the Neck

 

A penetrating neck injury is defined as one that penetrates the platysma.

 

Criteria for mandatory neck exploration:

(1) hemorrhagic shock

(2) continued arterial and/or venous hemorrhage (active bleeding from wound)

(3) massive or expanding hematoma

(4) vascular bruit over neck

(5) neurologic deficit secondary to arterial injury

(6) tracheal exposure

(7) wound blowing or sucking air

(8) dysphonia or hoarseness

(9) dysphagia

(10) hemoptysis

(11) subcutaneous emphysema

 

Management is affected by the zone affected (Zone I, II, III) and the number of penetrating injuries.