penetrating injury of neck

neck penetrating trauma & surgical zones of neck

zone 1	zone 2	zone 3
§  sternal notch/clavicle to cricoids §  includes thoracic inlet	§  cricoids to angle of mandible	small BUT critical area angle of mandible to skull base
§  major vascular structures----- vertebral artery §  proximal carotid artery §  subclavian artery & vein, jugular vein, §  common carotid artery, §  esophagus, §  thyroid, §  trachea. §  thoracic duct §  lungs	§  common carotid artery §  internal carotid §  external carotid §  jugular vein §  larynx §  hypopharynx §  CN X,XI,XII	internal and external carotid arteries, jugular vein, lateral pharynx, CN VII, IX, X, XI, and XII. salivary glands
§  highest mortality for wound in this zone	§  high risk injury to carotid sheath and aerodigestive system §  best prognosis

Bleeding is best controlled with direct pressure – with hand (not bandage pressure!) and thick dressing