Damage Control in Cervico-Thoracic’s Transition Wound: Case Report

Author(s): Vinicius Costa Lopes, José Augusto Pezati Tenani, Laura Ignacio da Cunha, Maycow Douglas Arantes, Tauane de Lima Fiorillo, Leticia da Silva Costa, Vinicius Trevizam Soares, Mateus Henrique da Silva Faria

The case addresses a patient who suffered a penetrating wound by a knife in right anterior cervical region (zone I) and left thoracic region that was admitted with signs of hemorrhagic hypovolemic shock (class III). The emergency surgical approach in patients with cervical trauma is indicated in cases of shock that is refractory to volume replacement, murmurs in the cervical region, and intense active bleeding. It is also suggested to avoid approaching non-expandable hematomas due to the risk of rebleeding. In this case, the patient had bleeding in the orifice of the cervical region and signs of shock. First, bleeding control was performed with Foley catheter placed in the wound and a massive transfusion protocol was initiated in the emergency room. Then, the patient was referred to the operating room. The management of penetrating neck injuries is based on anatomical division of the cervical region into zones I, II and III. Zone II is the area where most lesions are observed, followed by zones I and III.

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