gms | German Medical Science

Introduction: Knife assaults in England and Wales have risen by 16% according to latest figures this year. This study aims to evaluate the incidence of knife-related assault injuries, their clinical outcomes and operational and financial impact.

Methods: A retrospective analysis of knife assault injuries admitted with subsequent surgical episode in a single major trauma center between May 2015 and April 2018 was performed. Data was collected on demographics, injury patterns, treatment, complications, as well as operational and financial outcomes.

Results and Conclusions: A total of 228 patients were identified in the study period. Of these, 140 (60%) required plastic surgery input. The majority of patients were young (mean age 27.7 years; 71% of patients aged <30 years) and male (Male to female ratio 12:1). 42% of these patients sustained injuries in multiple anatomical regions, the upper limb being the most commonly injured site (72%). 30% (n=42) of patients required input from other specialties, especially Orthopedics (10%). Structures most commonly requiring repair were tendons (178 repairs in 52 cases), followed by muscle (73 repairs/51 cases) and nerves (70 repairs in 55 cases). 21 patients required vessel repairs with 4 requiring vein grafts. Mean operating time was 192 minutes and mean hospital stay was 3.5 days. The most common complications were neurological: 21% sensation deficit, 9% nerve palsy with an infection rate of 2%. Tariffs for the 140 cases totaled £732,136.

This study represents the first series from a major trauma center in West Midlands, United Kingdom. Knife-related violence and the resulted injury is not only a significant operational and financial burden to the NHS but can also have long- term functional consequences for patients.