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Significance of Mess Score in Upper Limb Vascular Trauma

Jayakrishnan R, Ilayakumar P, Devaraj .

Abstract


Objective: To  identitfy the significance of MESS score in patients with upper limb vascular trauma in a tertiary care  institute.

 Materials and Methods: Patient admitted at Rajiv Gandhi Government General Hospital, Chennai  between 2014 to 2016 with trauma to upper limb presenting with associated  acute limb ischemia  due to vascular injury . During          admission patients were selected for anatomic or extra          anatomic bypass due to multiple reasons, mostly due to trauma of the extremity affecting the anatomical tunnelling site. A  total of 20 patients underwent vascular repair with above indications . MESS score was calculated for all        patients.

Results: Of the twenty patients limb salvage was possible in 18 of 20 patients. Primary graft patency at the end of 1year was 80%. Early graft failure in 2 patients, late graft failure in 1 patient. anastamotic  pseudoaneurysm was the  result in 2 patients, 16 patients had functioning bypass at 1year.  Limb salvage was possible in  90% of patients  . 2 patients had primary amputation.

Conclusion: Inspite of the event of multiple factors rendering limb salvage impossible, appropriate and multi diciplinary approach to the patients  presenting  with acute limb          ischemia  in upper limb trauma with salvage of 90% limbs is even with high MESS scores . This signifies that MESS score is insignificant in upper limb vascular trauma.

 Keywords :  MESS score ,  extra anatomic bypass , limb salvage

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