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European Journal of Trauma and Emergency Surgery

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Open Access 30-11-2022 | Hemofiltration | Original Article

The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury

Authors: Alexandra Gratl, Michaela Kluckner, Leonhard Gruber, Josef Klocker, Sabine Wipper, Florian Karl Enzmann

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2023

Abstract

Purpose

Vascular injuries in lower extremity trauma, especially with involvement of the popliteal artery, are associated with considerably high rates of limb loss, especially with blunt trauma mechanisms. The aim of this study was to evaluate the risk of amputation in patients with traumatic popliteal artery lesions with special focus on the validity of the Mangled Extremity Severity Score (MESS).

Methods

In this retrospective study, all patients treated for isolated lesions of the popliteal artery following trauma between January 1990 and December 2020 at a high-volume level I trauma center were included. Primary outcome was limb salvage dependent on MESS and the influence of defined parameters on limb salvage was defined as secondary outcome. The extent of trauma was assessed by the MESS.

Results

A total of 50 patients (age 39.2 ± 18.6 years, 76% male) with most blunt injuries (n = 47, 94%) were included. None of the patients died within 30 days and revascularization was attempted in all patients with no primary amputation and the overall limb salvage rate was 88% (44 patients). A MESS ≥ 7 was observed in 28 patients (56%) with significantly higher rates of performed fasciotomies (92.9% vs. 59.1%; p < 0.01) in those patients. MESS did not predict delayed amputation within our patient cohort (MESS 8.4 ± 4.1 in the amputation group vs. 8.1 ± 3.8 in the limb salvage group; p = 0.765).

Conclusion

Revascularization of limbs with isolated popliteal artery injuries should always be attempted. MESS did not predict delayed amputation in our cohort with fasciotomy being an important measure to increase limb salvage rates.

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Title: The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury
Authors: Alexandra Gratl
Michaela Kluckner
Leonhard Gruber
Josef Klocker
Sabine Wipper
Florian Karl Enzmann
Publication date: 30-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hemofiltration
Vascular Trauma
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02179-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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