STAB WOUNDS TO THE NECK. TREATMENT IN THE CITY HOSPITAL. (CASE STUDY)
Authors:
Type:
Article
Pages:
from 0
to 0
Status:
Published
Received:
26.12.2014
Accepted:
26.12.2014
Published:
26.12.2014
Language:
Russian
Keywords:
clinical case, the wound, bleeding, hematoma, respiratory failure.
Abstract (English):
A clinical case study with patients with severe combined stab wounds to the neck and left shoulder. During the operation, the effective intubation wounded carried anesthetist available through a wound on the front of the neck, which communicates with the cavity ro-toglotki. Made a temporary stop bleeding by applying hemostatic zazhi-atoms. Intraoperatively administered broad-spectrum antibiotics. Introduced tetanus anatok-syn. With further audit revealed multiple injuries external jugular veins, facial veins and mandibular artery extending from the external carotid artery. Produced by ligation of these suck-ing, dressing which does not lead to a violation of cerebral circulation. Achieved sustained hemostasis. Next was performed upper tracheostomy: additional skin incision above the sternal notch. Mouth-stalled nasogastric tube, the wound washed abundantly with antiseptic solutions. Skill layering suturing mucosa of the oropharynx. Also gastrostomy was performed to unload the esophagus and postoperative enteral nutrition. At the same time packed red blood cells transfused, and fresh frozen plasma to replenish blood loss. Hyoid hemmed bottom to the soft tissues of the oral cavity, oropharynx restored. There are three silicone drainage tube into the cavity of the wound. Soft tissues are compared and sutured with interrupted sutures individual. After operation on the third day were removed from drainage surgery. On the 4th day postoperative period - the state of the injured is stable, heavy, in the mind of the patient is adequate. Recommended in such cases, pay particular attention to the ongoing external and / or roto-pharyngeal bleeding, signs of shock and acute massive blood loss. On hard or fast growing hematoma in the neck; on the dislocation, obstructive, stenotic, valves, suction asphyxia; on the growing phenomenon of respiratory failure; appearing on or exacerbated by focal neurological symptoms.
A clinical case study with patients with severe combined stab wounds to the neck and left shoulder. During the operation, the effective intubation wounded carried anesthetist available through a wound on the front of the neck, which communicates with the cavity ro-toglotki. Made a temporary stop bleeding by applying hemostatic zazhi-atoms. Intraoperatively administered broad-spectrum antibiotics. Introduced tetanus anatok-syn. With further audit revealed multiple injuries external jugular veins, facial veins and mandibular artery extending from the external carotid artery. Produced by ligation of these suck-ing, dressing which does not lead to a violation of cerebral circulation. Achieved sustained hemostasis. Next was performed upper tracheostomy: additional skin incision above the sternal notch. Mouth-stalled nasogastric tube, the wound washed abundantly with antiseptic solutions. Skill layering suturing mucosa of the oropharynx. Also gastrostomy was performed to unload the esophagus and postoperative enteral nutrition. At the same time packed red blood cells transfused, and fresh frozen plasma to replenish blood loss. Hyoid hemmed bottom to the soft tissues of the oral cavity, oropharynx restored. There are three silicone drainage tube into the cavity of the wound. Soft tissues are compared and sutured with interrupted sutures individual. After operation on the third day were removed from drainage surgery. On the 4th day postoperative period - the state of the injured is stable, heavy, in the mind of the patient is adequate. Recommended in such cases, pay particular attention to the ongoing external and / or roto-pharyngeal bleeding, signs of shock and acute massive blood loss. On hard or fast growing hematoma in the neck; on the dislocation, obstructive, stenotic, valves, suction asphyxia; on the growing phenomenon of respiratory failure; appearing on or exacerbated by focal neurological symptoms.
Keywords:
clinical case, the wound, bleeding, hematoma, respiratory failure.
clinical case, the wound, bleeding, hematoma, respiratory failure.
