From the Guidelines
Wound packing in the neck is not recommended due to the risk of compromising vital structures and the potential for severe complications. The management of neck wounds requires careful assessment and appropriate techniques to avoid causing further harm. According to the 2015 international consensus on first aid science with treatment recommendations 1, the correct management of hemorrhage and enhancement of hemostasis in the first aid setting are essential to maintaining circulating blood volume in acute trauma. However, this study does not support the use of wound packing in the neck.
Instead, neck wounds should be managed with:
- Careful assessment to determine the severity and extent of the injury
- Appropriate wound closure techniques, if possible
- Close monitoring for signs of complications, such as bleeding, swelling, or difficulty breathing
- Standard wound care, including gentle cleansing with normal saline and application of sterile dressings, for superficial wounds
- Immediate surgical evaluation for deep neck wounds, penetrating injuries, or those involving potential vascular or airway compromise
The neck contains critical structures, including major blood vessels, nerves, the trachea, esophagus, and thyroid gland, making blind packing potentially dangerous 1. Packing could inadvertently cause pressure on these structures, leading to complications such as airway compromise, vascular injury, or nerve damage. Any significant neck wound should be evaluated by a healthcare professional with appropriate expertise in head and neck injuries.
From the Research
Wound Packing in Neck Injuries
- The management of penetrating neck injuries is a complex process that requires careful evaluation and consideration of various factors, including the location and severity of the injury, as well as the patient's overall condition 2, 3.
- In general, wound packing is not typically recommended for neck injuries, as it can push debris and bacteria further into the wound and cause additional damage to surrounding tissues 3.
- Instead, the focus is on stabilizing the patient, controlling any bleeding, and assessing the injury to determine the best course of treatment, which may include surgical exploration or imaging studies such as CT scans 2, 3.
- The use of antibiotic prophylaxis may be considered in certain cases, such as when there is a high risk of infection or when the patient has a compromised immune system 4, 5.
- It's worth noting that the management of neck injuries can vary depending on the specific circumstances and the patient's individual needs, and should always be guided by current evidence-based guidelines and expert opinion 2, 3.