Stabbing / penetrating injury

Stabbing injury must be taken very seriously. A small and an apparently insignificant skin wound may hide considerable damage beneath if caused by a sharp flick knife.

Stab injury to the limb must be examined very carefully to exclude deep damage to nerve, vessel or muscle tendon. The limb should be x-rayed if there is a change that the bone cortex has been breached.

As a general principle, all stab injuries to the neck that have breached platysma, chest and abdomen should be referred to inpatient teams for formal exploration. These will usually be the General Surgeons. The practice of probing a knife tract to try and determine its depth is entirely unreliable. A knife tract that is oblique may enter the abdominal cavity some distance away from the skin wound. Another trap is that knife injuries and alcohol go hand in hand and alcohol is notorious at masking the early signs of peritonism and pain that could indicate visceral injury.

Do not send significant stab injuries home - admit surgical or monitor in CDU.

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 7/02/23.