Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 12 , ISSUE 3 ( September-December, 2023 ) > List of Articles


MESS Scale in Peripheral Vascular Trauma of the Lower Extremities: Experience at the High Specialty Regional Hospital Dr Gustavo A Rovirosa Perez

Enmanuel G de la Cruz, Raul B Cruz, Carlos A Mejía Picasso

Keywords : Femoral artery, Ischemia, Mangled extremity severity score scale, Vascular anastomosis, Vascular trauma of extremities

Citation Information : de la Cruz EG, Cruz RB, Picasso CA. MESS Scale in Peripheral Vascular Trauma of the Lower Extremities: Experience at the High Specialty Regional Hospital Dr Gustavo A Rovirosa Perez. Panam J Trauma Crit Care Emerg Surg 2023; 12 (3):131-135.

DOI: 10.5005/jp-journals-10030-1434

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: It is necessary to count on guides to decide whether to value an injured extremity, between saving it or amputating it, which is why Johansen et al. created its acronyms in English; the mangled extremity severity score (MESS) has the objective of determining the need to perform amputation objectively. The objective is to determine the usefulness of MESS in the management of peripheral vascular lesions of the lower extremity treated at the Hospital Dr Gustavo A Rovirosa Perez. Study design: The study was descriptive, retrospective, longitudinal, and nonexperimental. This includes patients with traumatic vascular injuries of the lower extremities, managed with revascularization. The variables are age, sex, MESS score, injury mechanism, injured vessel, and time between injury and surgery. Data is captured and analyzed on a table in the Excel software version 2019. Results: With a sample of 12 patients, 100% were male patients, and 58.3% were aged between 20 and 40 years. Around 66.6% were penetrating trauma, 58.3% due to PAF, and 8.3% due to blunt force. A total of 50% of all MESS points <7. All 16.6% went to the gym with time <6 hours of evolution. Finding lesions of the left popliteal artery in five patients, four of the right femoral artery, and three of the left femoral artery. The management in 58.4% was with autologous saphenous vein injection, and four patients had primary anastomosis. Conclusion: The literature reports a better prognosis in injuries with ischemia window time <6 hours. Therefore, it is necessary to consider the presence or absence of signs of irreversible ischemia and nervous impairment that impede the functionality of the extremities. Studies report that MESS has a predictive value of <50% for indications of amputation in patients with scores >7; however, it achieves a predictive value of salvation from the upper end of 100% in scores <7.

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