Naslov
Guidelines for Limb Amputation and Reconstruction in Mass-Casualty Incidents.

Autori
Bakota, Bore ; Kopljar, Mario ; Hrečkovski, Boris

Vrsta, podvrsta i kategorija rada
Poglavlja u knjigama, stručni

Knjiga
Handbook for Pandemic and Mass-Casualty Planning and Response.

Urednik/ci
Gursky, Elin ; Hrečkovski, Boris

Izdavač
IOS Press

Grad
Amsterdam

Godina
2012

Raspon stranica
168-172

ISBN
978-1-61499-134-2

Ključne riječi
Limb salvage, amputation, MESS score, leg injuries, surgery, decision making

Sažetak
Treatment of a mangled lower extremity represents a major challenge in mass-casualty incidents. The decision whether to amputate or attempt reconstruction is currently based upon surgical evaluation. The aim of this chapter is to propose a new approach to surgical evaluation based on scoring systems and local clinical status of the patient, as well as comorbidities, mechanism of trauma, and hospital resources. Based on current literature guidelines and evidence-based medicine, management for borderline cases is proposed to aid clinical decision making in these situations. Despite a borderline Mangled Extremity Severity Score (see Table II in K. Johansen et al.[1]), in some cases reconstruction can be attempted considering the overall health status of the patient and local clinical status, with preserved plantar sensitivity and satisfactory capillary perfusion. In conclusion, management of mangled extremity treatment should refer to evidence-based literature in correlation with clinical evaluation of every individual patient. Scores are helpful but should not be taken as a sole indication for amputation.

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

POVEZANOST RADA