Cut Throat Injury Research Articles

Airway Issues in Management of Severe Cut-Throat Injuries

<i>Introduction:</i> Open or incised anterior neck injuries inflicted by sharp implements may be described as Cut-throat injuries (CTIs). The managing team is immediately confronted with airway management options, therefore, a close collaboration between the surgeon and the anesthetist is required to adopt a strategy that will guarantee a safe airway and ensure a successful outcome. In this article, we discuss the factors that led us to perform tracheostomy before repair while avoiding a rule of tracheostomy for all. <i>Method:</i> A prospective study was conducted at Federal Medical Centre, Gusau, between January 2019 -August 2023. Nine (9) patients presented with zone II cut-throat injuries and the choice of airway management was discussed between the surgeon and the anesthetist focused on symptoms of air obstruction and findings within the larynx that could lead to airway obstruction once repair was done. <i>Result:</i> There were nine patients (9) with the age range of 18-60 years. Tracheostomy rate was 55.6% (n=5). There is a positive correlation (+1) between tracheostomy and laryngeal edema. A subset of patients, 22.2% (n=2) was selected for repair without a tracheostomy. <i>Conclusion:</i> The choice of perfect airway management should result from constructive collaboration between the surgeon and the anesthetist. Tracheostomy should be considered in patients with asymptomatic laryngeal edema.

Perceived benefit of antibiotics irrigation before pharyngeal repair of severe cut-throat injuries

IntroductionWound irrigation has been employed as an important surgical step to remove bacteria, devitalized tissues, and foreign bodies from surgical sites to prevent infection and confer to the wound maximum potential of healing. MethodA prospective study was conducted at Federal Medical Centre, Gusau, between January 2019- August 2023 to assess the benefit of antibiotics as additives in irrigation of dirty wounds.Seven (7) patients in total were presented with severe cut-throat injuries that require laryngopharyngoplasty. A combination of injection ciprofloxacin and metronidazole were used as additives into 1 L of normal saline, low pressure irrigation was done using 20mls syringe fitted to a broken needle or canular. Dysphagia Outcome and Severity Scale (DOSS) was used to assess return of pharyngeal function. ResultThe mean time of presentation of the patients was 34 ± 29 h (µ ± standard deviation) and a range of 6–72 h. The mean repair time was 58.3 ± 38.4 h with a range of 24–120 h. Most of the patients (85.7 %) had dysphagia outcome and severity scale of level 5 when per oral feeding was started with steady progress until discharge day. ConclusionWound irrigation is one of the most crucial steps in treating severe cut-throat injuries. Based on our experience, adding antibiotics to the irrigant has shown potential in the control of local infection, particularly where patients present late.

Clinical profile, treatment modalities and outcomes among patients with upper aero-digestive tract emergencies at Bugando Medical Centre, Mwanza, Tanzania

Background: Upper aero-digestive tract emergencies (UADTEs) are common in our setting and can be life-threatening and challenging to otolaryngologists. However, there is a paucity of clinical studies on these emergencies. This study aimed to determine the clinical profile, treatment modalities and outcomes of upper aero-digestive tract emergencies at Bugando Medical Centre (BMC), Mwanza, Tanzania. Methods: Between January and May 2019, a cross-sectional study involving patients presenting with a clinical diagnosis of UADTEs was conducted at BMC. Results: Of 487 ENT emergencies seen during the study period, 128 (26.3%) patients had UADTEs. Males outnumbered females by a ratio of 1.5: 1. Their median age at presentation was 5 [range, 2-40] years. The major causes of UADTEs were foreign body ingestion, head and neck tumours, foreign body aspiration and cut-throat injuries that were seen in 56(43.8%), 33(25.8%), 25(19.5%) and (3.9%), respectively. The most frequent presentations were dysphagia 81(63.3%), difficulty in breathing 61(47.7%) and odynophagia 56(43.8). Age ≤ 40 years (p=0.02), prolonged duration to treatment (p=0.04) and low blood oxygen saturation (SPO2) (p=0.04) were significantly associated with poor outcomes following esophagoscopy. In addition, delayed duration to treatment (p=0.01) and foreign body ingestion (p=0.001) were significantly associated with prolonged hospital stay. Conclusion: UADTEs are common at BMC and constitute a significant cause of otorhinolaryngological admission with foreign bodies in the aerodigestive tract as the most typical cause of these emergencies. Most of these injuries can be prevented through public enlightenment campaigns. Early detection and management of UADTEs is essential to reduce morbidity and mortality associated with these emergencies.

Severe Cut Throat Injury in a Child: A Case Report and Review of Literature

Severe Cut Throat Injury in a Child: A Case Report and Review of Literature

Clinical Profile, Treatment Modalities and Outcomes among Patients with Upper Aero-Digestive Tract Emergencies at Bugando Medical Centre, Mwanza, Tanzania

Background: Emergencies of the upper aero-digestive tract emergencies (UADTEs) are common in our setting, can be life threatening, challenging to the otolaryngologists and yet there is a paucity of clinical studies on these emergencies. This study aimed to determine the clinical profile, treatment modalities and outcomes of upper aero- digestive tract emergencies at Bugando Medical Centre (BMC), Mwanza, Tanzania. Methods: Between January and May 2019, a cross sectional study involving patients presenting with a clinical diagnosis of UADTEs was conducted at BMC. Data on socio-demography, clinical presentation, duration of symptoms, time interval between admission and intervention, type of intervention, postoperative complications and length of hospital stay were collected in questionnaire designed for the study. Ethical clearance was obtained from the Joint CUHAS/BMC Research, Ethics and Review Committee. Results: Of 487 ENT emergencies seen during study period, 128 (26.3%) patients had UADTEs. Male outnumbered females by a ratio of 1.5: 1. Their median age at presentation was 5 [range, 2-40] years. The major causes of UADTEs were foreign body ingestion, head & neck tumors and foreign body aspiration and cut-throat injuries that were seen in 56(43.8%), 33(25.8%), 25(19.5%) and (3.9%) respectively. The most frequent presentations were dysphagia 81(63.3%), difficulty in breathing 61(47.7%) and odynophagia 56(43.8). Poor outcome following esophagoscopy was associated with younger age (0-17 years) (p=0.02), prolonged duration to treatment (p=0.04) and low blood oxygen saturation (SPO2) (p=0.04). In addition, delayed duration to treatment (p=0.01) and foreign body ingestion (p=0.001) were significantly associated with prolonged hospital stay. Conclusion: At Bugando Medical Centre, UADTE pose a serious burden and challenge. Peripheral hospitals should be equipped with trained health workers and basic equipment to resuscitate and manage these patients before they are ......

Alcohol Withdrawal Presenting with Cut Throat Injury during COVID-19 Lockdown: Case Reports from Nepal

Background. The relationship between alcohol dependence and suicidal tendency is well recognized. Self-harm by cut throat is an uncommon but is potentially life-threatening when attempted. We present a description and discussion of a series of three cases of alcohol dependence syndrome who presented with self-inflicted cut throat wounds during the lockdown period from 24th March to 7th July 2020 due to the COVID-19 pandemic at the largest tertiary care hospital in Nepal. Case description. During the three and a half months of COVID-19 lockdown, we had three cases of alcohol dependence syndrome presenting to emergency services with a self-inflicted cut throat injury. Two cases were diagnosed as having alcohol withdrawal delirium and one case as alcohol-induced psychotic disorder (alcoholic hallucinosis) as per the international classification of mental and behavioral disorders diagnostic criteria for research. All three cases were alcohol dependent for more than a decade, but with no prior self-harm attempts. Necessary surgical interventions were done by the Department of Otorhinolaryngology, and in liaison with the Department of Psychiatry, appropriate psychiatric management was done. All three cases had uneventful outcomes in regard to wound care and mental disorder. Conclusion. Suicidal precautions should be taken in alcohol dependence during phases of consumption and abstinence. Screening for alcohol dependence and withdrawal should be a standard process in all self-harm cases that present to the emergency department during a crisis.

Suicidal cut-throat with medico-legal masquerades: case illustration and review of the literature

BackgroundFurnishing an opinion about the manner may be challenging for a forensic pathologist in cases of spot deaths with isolated cut-throat injury.Case presentationThis fatality in a young male is elucidated for it to be found markedly deviant with reference to the factors described for suicidal cut-throat injuries, including (1) medical history; (2) death circumstances (non-home); (3) type of object that produced injury; (4) injury pattern in relation to dexterity, lack of old and fresh hesitation cuts at neck and elsewhere, predisposition (horizontal), and extent (superficiality); (5) autopsy findings (non-pale organs); (6) scene evidence/s; (7) findings at viscera examination; and (8) cause of death (choking). The deceased was a cannabis addict, practiced black magic, and lived separated from his wife. There was no lead of the event, and thus an inquest proceeding was initiated.ConclusionThe possibility of suicide by cut throat by razor blade was considered in the light of the pragmatic comprehension of the post-mortem and scene findings. A case of suicide cut-throat without hesitation cuts, but with venous outpour, and not-so-deep injuries caused by a razor blade, has not been reported. This unprecedented review aims to add to the virtually non-existent literature about medico-legal masquerades rarely seen in suicide cut-throat injuries. It is an endeavor to guide the deduction of the most qualified opinion with a guide to analyzing often undermined and neglected variables in cases of isolated cut-throat injuries. The causative association of marital conflicts that put young males at an increased risk of suicide is highlighted here.

Our experience of cut throat injury at a tertiary care center during COVID-19 pandemic

Background: Cut throat injury is a least commonly attempted method of suicide or homicide. Neck injury may be suicidal, homicidal or accidental depending upon the etiology. Hesitation mark around the wound is favor of suicidal attempt and without hesitation mark is a rare possibility of suicidal attempt. Methods: This is a retrospective study carried out over period of one year, between April 2020 to March 2021, in a tertiary care center of north central India, during Covid-19 pandemic before the second wave. Results: Total 37 cases were attended; incidence was more common in male than female (34:3). Most commonly involved age group was 21 to 30 years, most of the patients belonged to rural background and manual workers. Homicide was the most common cause of injury and mostly under the influence of alcohol. Conclusions: Young males belonging to lower socioeconomic status and rural background were most common victims of cut throat injury in our study, homicide being the most common causative factor. Life of the patients can be saved with less morbidity and mortality by the means of good triage management and early intervention.

Understanding the Mode and Factors Influencing Cut-Throat Injuries in a Tribal-Dominated Population in Eastern India.

Introduction Traditionally, injuries have often been perceived as random and inevitable 'accidents'.However, in the current context, both intentional and unintentional injuries are preventable. Among these, neck injuries can be particularly complex, encompassing homicidal, suicidal, or accidental causes. Despite extensive research on the different modes and patterns of cut-throat injuries in the general population, this study aims to look deeper into this phenomenon within a unique context. Our investigation is centered in the Eastern part of India, among a tribal-dominated populationwho live with their traditional culture. Method In this prospective observational study, 50 cut-throat patients were included, who reported to the emergency department and then were referred to the ENT department. Parameters such as age, sex, anatomical location, mode of cut-throat injury, prior substance abuse, psychiatric issues, socioeconomic level, and length of hospital stay were considered for analysis. Results The majority (n=40, 80%) of patients belonged to tribal communitiesand most were young adults. Cut-throat injuries were predominantly caused by suicide (n=36, 72%) and homicide (n=12, 24%). Among tribals, 85% (n=34) of the cases were suicidal. Among suicidal cases, 86.11% (n=31) had a history of substance abusewhile 22.22% (n=8) had a history of psychiatric illnesses. Conclusion In Eastern India, among the tribal-dominated population, suicide emerges as the predominant mode of cut-throat injuries, which is notably distinct from patterns observed in the general population of developing countries. These were often associated with substance abuse.Future interventions and public health efforts in these regions should consider these factors in the development of targeted strategies aimed at prevention and support for at-risk individuals.

Suicide by sharp force associated with major self-mutilation and self-cannibalism.

Self-stabbing and self-cutting represents an uncommon method of suicide. We present a case of a 30-year-old man who was found dead in the forest. The body was naked and showed multiple cut and stab wounds on different parts of the body (face, neck, chest, abdomen, and extremities). A single-edged kitchen knife was found approximately 20m from the body. Parts of both ears, the fifth toe of the right foot, and the scrotum were cut off. At the autopsy, two of the severed body parts-the toe and the part of the left ear-were found in the stomach. The cause of death was asphyxiation due to blood aspiration resulting from a cut throat injury. A police investigation uncovered a history of substance abuse and two previous suicidal attempts using a knife. Upon complex analysis of all the evidence, the manner of death was ruled a suicide, which was preceded by actions of major self-mutilation and self-cannibalism, both considered rare behavioral patterns.

Our Experience with Cut Throat Injury Cases in a Rural Tertiary Care Centre

ABSTRACT Background: Cut throat injuries are one of the most challenging surgical emergencies encountered by Ear, nose, throat (ENT) surgeons. If not treated in time, they may lead to death. Prevention of mortality depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of bleeding, and wound closure. Aims and Objectives: Our study was conducted to observe and analyze: 1. The sociodemographic profile of cut throat injury patients admitted in our hospital. 2. The modes of cut throat injury cases admitted in our hospital. 3. Anatomical region and depth of the cut throat injury patients admitted in our hospital. 4. Treatment of cut throat injury patients given at our hospital. Materials and Methods: This is a prospective study of about 25 cases of cut throat injury presented to the emergency department in our tertiary care hospital situated in the rural area of Tamilnadu (India), between June 2021 and September 2022. Cut throat injury patients were managed by multidisciplinary approach headed by the ENT team. Results: In our study, 72% were males and 28% were females. The peak age of incidence is fourth decade (48%). People with lower socioeconomic status were affected more (40%). Eighty percent of the patients had Zone II injuries. Seventy-six percent of cases presented with active bleeding and 60% of cases came with breathing difficulty. The most common cause of cut throat injury had been found to be suicidal (52%). Sixty percent had laryngeal injuries. Seventy-two percent of the cases were managed with tracheostomy. Conclusion: Our study found that the majority of cut throat injury patients were males of age between 30 years to 40 years from poor socioeconomic status. Social involvement and political motivation, poverty reduction, individual awareness, increase in economic growth along with literacy rate will prevent the cut throat injuries. Early and improved proper management will reduce the mortality and morbidity.

THE PATTERN OF CUT THROAT INJURIES, EARLY MANAGEMENT AND OUTCOME-A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL

Objective: To analyze pattern, sex and age ratio, common causes, the most common site and extent of the injury in the patients with cut throat injury at our hospital. To compare the same with previous similar studies conducted at other centers in different parts of the world. Also to note the early management and outcome in our study. Department Setting: of ENT and Head and Neck Surgery, Gauhati Medical college and Hospital, Guwahati, from January 2022 to January 2023. Methods: A total of 60 cases of cut throat injury were included in our study. Proforma was prepared to collect data. Results: 60 cases of cut throat injury patients were included in the study. Out of 60 cases 51 were males and 9 were females. Simple primary wound closure was done in 58 cases and 2 required secondary wound repair. In 20 patients, tracheostomy with primary repair was done. 32 patients needed psychiatric consultation. In our study, Conclusion: majority were males between 20 years to 40 years from lower middle socioeconomic status. Early and improved management will reduce the mortality and morbidity

LARYNGOTRACHEAL TRAUMA MANAGEMENT AND ASSOCIATED MORBIDITY AND MORTALITY: 4-YEAR EXPERIENCE AT A TERTIARY CARE CENTER

Objective: Cut throat injuries pose a great therapeutic challenge due to the multiple vital structures that are vulnerable to injuries in a small, confined unprotected area. In this study, we describe the site and depth of the injury, etiology, management, and prognosis. Methods: This was a retrospective study of 18 laryngotracheal trauma patients treated at the department of ENT in MDM hospital between April 2017 and January 2020. Results: Out of 176 cases of penetrating neck injury, 18 patients presented with a breach in the laryngotracheal framework. Male: female ratio was 17:1. The peak age of incidence is in the 2nd and 4th decade of life. Accidental cut throat injury was the most common mode of injury (83%), followed by homicidal (11%) and then suicidal (5%). Endotracheal intubation (where possible) or emergency tracheostomy was done to secure the airway in all the cases, followed by surgical debridement and laryngeal/hypopharynx repair. Post-operative endoscopy is useful to identify complications. Wound dehiscence was the most common complication. Conclusion: Cut throat injuries are one of the common ENT surgical emergency. Timely intervention is paramount, because it may otherwise cause death of the patient. Securing the airway, control of hemorrhage, and fluid and blood replacement is the mainstay to prevent complications such as shock, sepsis, laryngeal stenosis, or fistula formation.

A clinico epidemiological study of cut throat patients – An observational retrospective study at tertiary care hospital in Jharkhand, India

Background: Cut throat injury is an incised wound in the neck that may be superficial or deep and is usually caused by sharp objects. These wounds may be from homicide, suicide, or accidental. Aims and Objectives: The purpose of this study was to assess cut throat injury in terms of age, sex, site of injury, and triggering factors for suicidal cut throat injury. Materials and Methods: This retrospective study was carried out in the Department of ENT, Rajendra Institute of Medical Sciences. The study included 35 cut throat patients who were admitted and managed in the ENT department. Data were analyzed with detailed history as age, sex, cause, site of injury, sociodemographic pattern, and history of substance abuse, psychiatric problem, and duration of hospital stay. Results: Out of 35 patients, 32 were male and three were female. The majority of the patients 21 (60%) were young adults. Causes of cut throat were suicidal 77.14% followed by homicidal 20%. The majority of patients had Zone II injuries. In general, the patients belonged to the lower middle socioeconomic class. About 77.8% of patients with suicidal cases were found to be addicted to one more substance and 22.2% were having some psychiatric illness. The most common substance abuse was indigenous rice beer Hadia mahua. Conclusion: Young adults of the low socioeconomic class were most vulnerable to cut throat injury with a majority having zone II injury. Suicide was the most common cause with substance abuse proving to be a major provoking factor in addition to unemployment, illiteracy, and poverty.

Accidental Cut Throat Injury by an Unusual Weapon: A Rare Case Report

Accidental Cut Throat Injury by an Unusual Weapon: A Rare Case Report

Spectrum and Possible Appropriate Technology for Specific Protection against Cutthroat Kite String “Manja” Injury

Every year the auspicious festival of Makar Sankranti is jolted by incidences of cutthroat injuries or deaths because of kite string “Manja.” Bike riders are the majority of victims of such mishaps. In view of sporadic and seasonal reporting, to know the burden of kite string injury and its possible preventive measure, we conducted a literature search using Boolean search strategy with keyword such as “Kite string and injury, manja and injury, bikers and cutthroat injury” on medical databases such as PubMed, Semantic Scholar, and Google Scholar. Search was also made on digital print media with same keywords on Google and subscription free and full-text articles available in PDF format were reviewed. Literature review made us realize that there is wide spectrum of kite string injuries of which most common is a grievous cutthroat injury but preventive and mitigation measure for such injuries were surprisingly missing. Hence, we also discuss a possible protective role of inverted “U” shaped aluminum bar/guard installed on bike by Gujarati community during Uttarayan (Makar Sankranti), adoption of which can act as specific protection against cutthroat kite string injuries and help prevent biker’s deaths.

An atypical suicidal cut throat injury- Mechanism uncovered after injury interpretation

Suicide is an intentional act of injuring oneself, irrespective of the outcome. However, there are other forms of suicidal behaviour existing among the people. The year 2020 is a hard time due to COVID19 pandemic as it had created difficulty to many people especially the lower economic class people to meet their daily livelihood. The result is many poor victims committing suicide. The method used for committing suicide vary from region to region. However, cutting one's own throat to end their life is very rarely performed by the victims of suicide. A careful interpretation of the injury is required by the forensic pathologist to conclude the manner of the death in such deaths. Here we report one such case, and the manner is concluded after studying the injuries tediously in summation with the police investigation.

Fatal cut-throat injury of the neck by kite string

Flying kite is a common sport among children and even in the adult age group. Falls, cut wounds, head injuries, and fractures account for the bulk of accidents and injuries encountered while flying kites. Neck injury from a basic kite string is uncommon. Injury by kite string ranges from small cuts to major lacerations or even head trauma. The amount of abrasive material that is commonly placed on the kite's string to boost its cutting capacity determines the severity of the laceration injury. The preventive measures are to fly kites in a safe area and requirement of raising awareness of potential complications of this sport. A 56-year-old man arrived with a clean-cut, deep-incised wound that exposed the strap muscles and fat and required primary closure.

Unusual case of a survivor of a self-inflicted suicidal cut-throat injury

Unusual case of a survivor of a self-inflicted suicidal cut-throat injury

Cut Throat Injury: A Tertiary Care Centre Experience

Introduction Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries. Materials and Methods This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing. Results In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement. Conclusion The middle aged males were mostly affected. The majority had zone 2 injury. The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.