Machete related injuries: A critical retrospective review of 538 cases managed at a major trauma centre in South Africa

Introduction Although machete-related injuries are common in South Africa, there is no comprehensive review of the spectrum and outcome of these patients and their injuries. This study aims to address this deficit by reviewing our institutional experience in managing such injuries over the past 12 years. Materials and Methods A retrospective study was conducted on all patients with machete-related injuries from January 2013 to December 2024 at a major trauma centre in South Africa. Results A total of 538 cases were included (91% male, mean age 33 years). The median Injury Severity Score (ISS) was 9 (IQR 5–12). The head, face and upper limb were the most commonly injured regions, with 58% of all patients sustaining injuries to multiple body regions, 19% requiring operative interventions, 10% (51/538) sustaining at least one complication and 4% (21/538) requiring intensive care unit admission. The mean length of hospital stay was three days. The overall mortality rate was 2% (11/538). The mean number of cases per year was 45. Conclusions Assault with a machete is not infrequent and results in multiple injuries, which are not confined to single body regions. The most frequent body regions injured include the exposed areas of the head, face and upper limbs. Care needs to be coordinated between a variety of subspecialties and must include allied medical professionals to ensure optimal recovery.