Elsharawy Mohamed Amin
Surgical Department, Suez Canal University, Ismailia, Egypt.
Vascular. 2005 Mar-Apr;13(2):114-9. doi: 10.1258/rsmvasc.13.2.114.
The Vascular Unit at Suez Canal University Hospital in Egypt covers a wide area with high rates of severe injuries. This is a prospective study of mangled extremities to identify risk factors associated with limb loss in these patients. Between December 2000 and August 2003, a prospective study on all patients with arterial injuries in mangled extremities was undertaken. All patients were scored using the Mangled Extremity Severity Score (MESS) and the Mangled Extremity Severity Index (MESI). During this period, arterial reconstruction was performed in 62 patients. Primary patency, secondary patency, and limb salvage rates were 81%, 85.5%, and 93.5%, respectively. The only factor affecting limb salvage (statistical trend) was the site of trauma (upper limb 100% vs lower limb 89%; p = .08%). There was no significant effect related to the mechanism of trauma (blunt 90% vs stab 100%; p = .125), MESS (< 7, 100% vs > 7, 91%; p = .22), and MESI (< 20, 100% vs > 20, 90.5%; p = .154). Upper limb injuries were the least likely to lead to amputation. We recommend that all injuries, whatever their score, should be surgically explored before treatment decisions are made.
埃及苏伊士运河大学医院的血管科负责的区域范围广，重伤发生率高。这是一项关于严重毁损肢体的前瞻性研究，旨在确定这些患者肢体缺失的相关危险因素。2000年12月至2003年8月，对所有严重毁损肢体的动脉损伤患者进行了前瞻性研究。所有患者均使用肢体损伤严重程度评分（MESS）和肢体损伤严重指数（MESI）进行评分。在此期间，对62例患者进行了动脉重建。一期通畅率、二期通畅率和肢体挽救率分别为81%、85.5%和93.5%。影响肢体挽救（统计学趋势）的唯一因素是创伤部位（上肢100%，下肢89%；p = 0.08%）。创伤机制（钝性伤90%，刺伤100%；p = 0.125）、MESS（<7分，100%，>7分，91%；p = 0.22）和MESI（<20分，100%，>20分，90.5%；p = 0.154）均无显著影响。上肢损伤导致截肢的可能性最小。我们建议，在做出治疗决策之前，应对所有损伤进行手术探查，无论其评分如何。
