Rajat Jain

Cut Throat Injury Presenting As Emergencies in a Tertiary Care Hospital in India: A Retrospective Analysis

Anterior neck injuries are variable according to their extent, depth and cause. These can be intentional or accidental. The injuries may be penetrating or non-penetrating. Injury to certain anatomic structures (e.g, carotid or subclavian vessels) may be fatal in two thirds of cases. Management of injuries that penetrate the platysma depends upon the anatomic level of injury. A retrospective study of 30 cases of cut throat injury presenting as emergency were managed over a two year period from June 2010 to June 2012. They were analysed for details of age, sex, etiology, nature of injury and surgical procedures for management and their complications. A total of 30 cases of cut throat injuries were reviewed. 20 females, 10 males with age ranging from 5 to 60 years, mean age of 21.2 years. 13 cases were suicidal, 10 cases were attempted homicidal, 3 were from animal assault, 2 were as a result of road traffic accident and remaining 2 patients were due to fall on sharp object. Sharp knife was used in all cases of attempted suicide and 80% cases of human assault, while cow horn was the most common object involved in animal assault. Bullet was observed in two cases of gunshot. Four patients had pharyngocutaneous fistula, one developed tracheopharyngeal fistula, One developed wound dehiscence in post-operative period. Suicidal and homicidal wounds account for majority of the cases (76.66%). Cut throat injuries presenting as emergency differ in etiology, extent, and depth. Early intervention in the form of airway management and meticulous repair layer by layer is needed for surgical repair. Complications developed as a result of bad initial management & poor health of patients. Proper initial management & early repair of the ‘cut-throat injury’ reduces complications and post-operative morbidity. Post-operative follow-up for at least one year is needed to avoid delayed complications and hence morbidity.