The purpose of this study was to evaluate the efficacy of the no zone approach in traumatic neck injuries. In contrast, the decision to perform a surgical treatment in hemodynamically stable patients is controversial. If the patients are hemodynamically unstable or indicate confirmed hard signs, such as active bleeding or severe emphysema, surgery or other therapeutic procedures like angioembolization should be considered without further examination. This selective operation is based on the “no zone” approach in which one determines the treatment method based on the classification of the symptoms that may have resulted from damage to the major vascular, digestive, and respiratory systems. Therefore, the management of neck injuries has changed from a mandatory exploration of all wounds that penetrate the platysma to a more selective approach based on patient symptoms. However, routine neck exploration in hemodynamically stable patients is reportedly known to result in a high rate of negative exploration, longer hospital stay, and an increased rate of complications, such as surgical site infections and sepsis. This approach has been referred to as the zone-based algorithm and has been used as a traditional assessment for traumatic neck injuries. Therefore, mandatory exploration is generally performed in cases of zone II injuries, according to the classification of the anatomical zones of the neck: zone I spans from the clavicles to the cricoid zone II spans from the cricoid to the angle of the mandible and zone III ranges from the angle of the mandible to the base of the skull. Anatomical features like the trachea, esophagus, great vessels, and nerves are crowded in small spaces and are relatively unprotected. Despite its low incidence, the number of mortalities due to neck injury has still been high (10%–15%). Traumatic neck injury comprises approximately 5%–10% of all traumatic injuries.
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