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Mon Aug 7 20:15:58 BST 2006

 From what you describe, doing surgery now would represent the classic case of treating an X-ray rather than the patient... Why do anything at all???  The patient is doing fine extubated--obviously the wound has healed, IF it was ever there really to begin with--the more probing around you do with scopes or knives, the more likely you will muck up God's work.  Any other investigation would only be to satisfy your curiosity as opposed to help  the patient--the latter is always more important than the former
ERF

-----Original Message-----
From: drnavingoyal at yahoo.co.in
To: trauma-list at trauma.org
Sent: Mon, 7 Aug 2006 8:54 AM
Subject: Traumatic Neck Wound

30 yr. old male attende my trauma ward . He had trauma as a large glass slab 
fell over his neck and chest . He had a wound in the neck just above the 
clavicle which was bubbling and bleeding . There were fractures in the ribd with 
bilateral decreased air entry on both side . There was collection of Blood in 
the mouth . Patient was immediately intubated . Bilateral Chest tubes were put 
and by the time the wound was explored it had stopped bubbling , bleeding was 
located to vessel in the muscle which was ligated and the wound closed .

  Later on CT of the neck and chest done which showed rent in the posterolateral 
aspect of the trachea  above the carina. Surgical emphysema  in the neck has not 
increased rather slightly decreased. Patient is perfectly stable now he has been 
extubated . 

  Should we still do a surgical closure of the rent in the trachea??

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