Significance of Mess Score in Upper Limb Vascular Trauma
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 salvageFull Text:
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