Which one of the following is NOT a principle followed in the management of missile injuries?

Question

Image below highlights jugular foramen. Which of the following structures do not pass through the marked structure “A”?

Answer 1

This question is best approached by remembering that missile wound debridement removes dead tissue but preserves anything with a blood supply.

Excision of all dead muscles: a genuine principle — devitalised muscle must be removed to prevent infection.
Removal of foreign bodies: a genuine principle — retained debris is a nidus for infection.
Removal of fragments of bone: not a blanket principle — only loose, detached fragments are removed; fragments still attached to periosteum are kept.
Leaving the wound open: a genuine principle — the wound is closed only later, once clean.

Correct answer: Removal of fragments of bone.

Answer 2

This question is best approached by remembering that missile wound debridement removes dead tissue but preserves anything with a blood supply.

Excision of all dead muscles: a genuine principle — devitalised muscle must be removed to prevent infection.
Removal of foreign bodies: a genuine principle — retained debris is a nidus for infection.
Removal of fragments of bone: not a blanket principle — only loose, detached fragments are removed; fragments still attached to periosteum are kept.
Leaving the wound open: a genuine principle — the wound is closed only later, once clean.

Correct answer: Removal of fragments of bone.

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