ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 141-144

The validity of the mangled extremity severity score scoring system for lower limb vascular trauma in a tertiary care center


1 Department of Vascular and Endovascular Surgery, Yashoda Hospital, Hyderabad, Telangana, India
2 Department of Orthopaedics, Yashoda Hospital, Hyderabad, Telangana, India
3 Department of Plastic Surgery, Yashoda Hospital, Hyderabad, Telangana, India
4 Department of Anaesthesia, Yashoda Hospital, Hyderabad, Telangana, India

Correspondence Address:
Dr. Aryala Shalini
Department of Vascular and Endovascular Surgery, Yashoda Hospital, Hyderabad, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_63_19

Rights and Permissions

Purpose: Among all the scoring systems to predict limb salvage versus amputation after a complex trauma, MESS scoring system is considered to have good sensitivity and specificity. MESS scoring system is most widely used scoring system for the last more than 25 years. However when we applied MESS scoring system in our set of patients, it would not correlate with the need of amputation (for MESS score more than 7) and resulting in significant number of limb salvage. Methods: This a prospective study of 60 patients over a period of two years from June 2017-June 2019. All the patients of lower limb vascular trauma were examined and operated by the same team involving vascular surgeon, orthopedic surgeon and plastic surgeon. MESS scoring system was applied for all the patients. Patients with life threatening injuries were excluded in this study. Results: Between June 2017-2019, 60 patients were entered into the study. The majority were male with mean age of 30 years (Range 11-65years). Road traffic accidents with open injuries were the commonest mechanism of injuries (60%) and popliteal artery was involved in majority of injuries. Out of 35 patients of MESS score more than 7, in 28 patients leg was salvaged with the help of vascular,orthopedics and plastic reconstructions and remaining 7 patients underwent secondary amputation. The hospital stay and the finances involved in the treatment was high in patients with MESS score more than 7, where revascularisation was performed. However in the end psychological assessment of these patients and their family members was very encouraging. Conclusions: With the availability of a dedicated trauma team (which include vascular, orthopedic, plastic surgeons & anaesthetist) and improvement in the diagnostic and treatment modalities, the rate of limb salvage has increased significantly, hence reducing the prediction of MESS scoring system for an amputation. We conclude from our study that majority of lower limbs were salvaged in spite of MESS score being more than 7. We suggest with a word of caution for an amputation directly with a MESS score of more than 7 in all patients.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed76    
    Printed0    
    Emailed0    
    PDF Downloaded13    
    Comments [Add]    

Recommend this journal