Abstract
Summary. Combat injury of the limbs is characterized by multilevel open combined tissue damages, the severity of which in some cases makes it impossible the salvage tactics.
Objective: based on the analysis of literature, to investigate the possibility of using MESS (the mangled extremity severity score - assessment of the severity of a broken limb) when establishing indications for early amputation of a severely injured limb due to a combat trauma.
Materials and Methods. A literature search was conducted on the PubMed database according to the established criteria. Data were taken from the selected sources: the number of amputation/save cases and the weighted average MESS amputation/save value. A weighted average MESS with a 95% confidence interval (CI) and a coefficient of variation were calculated.
Results. A total of 189 sources according to the established criteria were identified for the period 1990-2021, in which MESS was applied; 7 sources were selected for analysis. The generalizing value (weighted average) for MESS for amputations was 7.3; 95% CI (6.27-8.33); the coefficient of variation was 4.1. While preserving the limb, the calculations showed a MESS value of 4.9; 95% CI (4.49-5.31); the coefficient of variation was 8.4.
Conclusions. The use of the MESS makes it possible to assess the condition of the injured limb; the value of 7 or above is a reliable predictor for amputation.
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