Issa Youssouf Nabila, Khan Huba Ali, Ahmed Osman Mohamed Asma, Bahaa Aboelsebaa Othman Mohamed, Ismail Mahmoud Hassan Fadul, Hassan Ahmed A, Alkhazendar Aliaa H, H J Alkhazendar Jarallah, Zehra Monezahe, Aakash Deewan
Surgery, International University of Africa, Khartoum, SDN.
Emergency Medicine, Ziauddin University, Karachi, PAK.
Cureus. 2025 Jun 17;17(6):e86252. doi: 10.7759/cureus.86252. eCollection 2025 Jun.
This systematic review explores the impact of multidisciplinary team (MDT) approaches in the management of complex limb injuries, comparing limb salvage and amputation outcomes across diverse trauma settings. Drawing from six recent studies involving both acute and chronic extremity trauma, the findings highlight consistent benefits of coordinated care involving orthopedic, vascular, and plastic surgery specialties. These include reduced flap loss, faster time to definitive fixation, improved functional recovery, and enhanced decision-making regarding salvage versus amputation. While functional and psychological outcomes following salvage and amputation were often comparable, early MDT involvement improved wound healing and lowered short-term mortality rates in select patient groups. Variability in outcomes was influenced by institutional resources, timing of intervention, and patient comorbidities. Scoring systems such as the Mangled Extremity Severity Score (MESS) and the Mangled Extremity Syndrome Index (MESI) aided but did not replace clinical judgment. Overall, the integration of multidisciplinary pathways into trauma care enhances outcome quality and supports patient-centered decision-making in complex limb trauma cases.
本系统评价探讨了多学科团队（MDT）方法在复杂肢体损伤管理中的影响，比较了不同创伤环境下肢体挽救和截肢的结果。基于最近六项涉及急性和慢性肢体创伤的研究，研究结果突出了骨科、血管外科和整形外科等多专科协作护理的持续益处。这些益处包括皮瓣丢失减少、确定性固定时间缩短、功能恢复改善以及在挽救与截肢决策方面的优化。虽然挽救和截肢后的功能及心理结果通常相当，但早期多学科团队的参与改善了伤口愈合，并降低了特定患者群体的短期死亡率。结果的差异受到机构资源、干预时机和患者合并症的影响。诸如肢体损伤严重程度评分（MESS）和肢体损伤综合征指数（MESI）等评分系统有辅助作用，但不能取代临床判断。总体而言，将多学科路径整合到创伤护理中可提高结果质量，并支持复杂肢体创伤病例中以患者为中心的决策制定。
