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Foley Catheter Balloon Tamponade for Actively Bleeding Wounds Following Penetrating Neck Injury is an Effective Technique for Controlling Non-Compressible Junctional External Haemorrhage

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Abstract

Background

The foley catheter balloon tamponade (FCBT) has been widely employed in the management of trauma. This study reviews our cumulative experience with the use of FCBT in the management of patients presenting with a penetrating neck injury (PNI).

Methods

A retrospective study was conducted at a major trauma centre in South Africa over a 9-year period from January 2012 to December 2020. All patients who presented with a PNI who had FCBT were included.

Results

A total of 1581 patients with a PNI were managed by our trauma centre, and 44 (3%) patients had an FCBT. Of the 44 cases of FCBT, stab wounds accounted for 93% (41/44) and the remaining 7% were for gunshot wounds. Seventy-five per cent of all FCBT (33/44) were inserted at a rural hospital prior to transfer to our trauma centre; the remaining 25% (11/44) were inserted in our resuscitation room. The success rate of FCBT was 80% (35/44), allowing further CT with angiography (CTA) to be performed. CTA findings were: 10/35 (29%) positive, 18/35 (51%) negative, and 7/35 (20%) equivocal. Fifteen patients required additional intervention (open surgery or endovascular intervention). The overall morbidity was 14% (6/44). Eighteen per cent required intensive care unit admission. The median length of stay was 1 day. The overall mortality rate was 11% (5/44).

Conclusion

FCBT is a simple and effective technique as an adjunct in the management of major haemorrhage from a PNI. In highly selective patients, it may also be used as definitive management.

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Data availability

The raw data used for this study are available on Figshare. https://doi.org/10.6084/m9.figshare.17047868.

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Funding

The authors have no sources of funding to declare for this study.

Author information

Authors and Affiliations

  1. Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa

    Victor Kong & Damian Clarke

  2. Trauma Service, Department of Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand

    Victor Kong

  3. Department of Surgery, University of Auckland, Auckland, New Zealand

    Jonathan Ko, Bogo Lee & Manar Khashram

  4. Department of Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

    Cynthia Cheung

  5. Department of Surgery, Waikato Hospital, Hamilton, New Zealand

    Priscilla Leow & Varun Thirayan

  6. Department of Surgery, University of KwaZulu Natal, Durban, South Africa

    John Bruce, Grant Laing & Damian Clarke

  7. Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand

    Manar Khashram

Authors
  1. Victor Kong
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  2. Jonathan Ko
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  4. Bogo Lee
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  7. John Bruce
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  8. Grant Laing
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  9. Manar Khashram
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  10. Damian Clarke
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Corresponding author

Correspondence to Victor Kong.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

Ethical approval for this study and maintaining the registry has been granted by the Biomedical Research Ethics Committee (BREC) of the University of KwaZulu Natal (Reference number: BE 207/09).

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Where applicable, informed consent and permission for the use of clinical photographs have been obtained from patients.

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Kong, V., Ko, J., Cheung, C. et al. Foley Catheter Balloon Tamponade for Actively Bleeding Wounds Following Penetrating Neck Injury is an Effective Technique for Controlling Non-Compressible Junctional External Haemorrhage. World J Surg 46, 1067–1075 (2022). https://doi.org/10.1007/s00268-022-06474-4

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  • DOI: https://doi.org/10.1007/s00268-022-06474-4

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