Key points:
- A 28-month retrospective review from February 2019 to April 2021 of
penetrating neck injuries (PNIs) at our trauma centre revealed a 48%
(n=25 to n=37) increase in PNIs ‘post-lockdown’ (lockdown date =
23rd March 2020).
- The aetiology of PNI changed over time, with an increase in the
proportion of Deliberate Self Harm’ (DSH) cases from 1/3 to
2/3rds of case (n=9 to n=25), an overall 177.8%
increase ‘post-lockdown’. An increase in mortality was also seen with
no deaths ‘pre-lockdown’, and 3 deaths ‘post-lockdown’.
- ‘Accidental Injuries’ (AI) increased from 4% to 10% of cases (n=1 to
n=4) post lockdown, with ‘grievous bodily harm (GBH) reducing from
half to 1/5th of all cases (n=13 to n=8), and
‘domestic violence’ from 8% of cases to no cases (DV) ‘post
lockdown’.
- ‘Pre-lockdown’ 10% of DSH patients (n=1) were noted to have a prior
mental health diagnosis or psychiatric care, ‘post-lockdown’ this
increased to 61.5% (n=16) of DSH patients.
- Data from our tertiary trauma centre in London has shown a change in
aetiology, psychiatric co-morbidity and number of PNIs pre and post
lockdown.
Introduction:
Penetrating Neck Injuries (PNIs) are defined as a trauma which breaches
the platysma (1). They are considered an uncommon but serious
presentation which may require immediate treatment due to potential
adverse outcomes (2). Generally, the treatment for PNIs can be
classified into immediate surgical treatment, delayed surgical treatment
and conservative (most commonly closure under local anaesthetic)(3).
Whilst globally GBH and gunshot wounds account for the majority of PNIs,
Deliberate Self Harm (DSH) and other accidents are responsible for a
significant proportion in the United Kingdom (4). St George’s University
Hospital is a major London trauma centre covering a wide geographical
population of 3.5 million and receives a large number of trauma patients
through its Emergency Department (5).