Limbs Openness Damage Patients Select Amputation Operation Or Limb-salvage Surgery Using Mangled Extremity Security Score (MESS): 19 Cases

Objective Analysis and summarize the clinical excellence and Treatment experience Of patients with Limbs openness damage.Methods Retrospective investigation 19 patients with Limbs openness damage treated in our hospital during 2009 January to 2011 Jannuary,8 male and 11 female.16-63 years old, Average 37 years old.6 of them over 50 years old,5 of them suffered from upper limb injury,11 of them suffered from lower limb injury,3 of them suffered both. Each of them had Muscle tissue damage,9 of them had vessels or nerves injury,7 of them had bone fracture in injury limbs,3 of them had bone fracture in other limbs,4 of them had a large area of skin absence. All the patients were taken grade of mangled extremity security score (MESS).6 of them were grade of MESS≥7,13 of them were grade of MESS< 7,7 of them came into the hospital after injury over 6 hours,12 of them came into the hospital after injury less than 6 hours.Treatment:6 patients got emergency amputation operation, while 13 patients got Limb-salvage surgery. After operation,all of patients had treatment with anti-inflammatory, relieving pam.Result all of them got follow-up,10 month average,4 of the 6 patients who had emergency amputation operation recovered well, had suitable artificial limb,1 of the 6 patients Incision scar hyperplasia,4 of the 6 patients had phantom limb pain, last for 3 to 10 month, the average time being in hospital of them were 18 days, the average cost being in hospital of them were 16000 CNY.8 of the 13 patients had Limb-salvage surgery recovered well,2 of the 13 patients had second operation because of limbs infection and necrosis,2 of the 13 patients had afunction or hypofunction of the injury limbs,1 of the 13 patients had osteomyelitis after operation, the average time being in hospital of them were 33 days, the average cost being in hospital of them were 68000 CNY.Conclusion amputation operation has less time, less complication, less cost, some of the patients will have phantom limb pain. While Limb-salvage surgery is harder, have more time, more complication, more cost,some of the patients will have afunction or hypofunction of the injury limbs.In permission of the patients'health, we shall do Limb-salvage surgery when grade of MESS< 7,while we shall do amputation operation when grade of MESS≥7.The grade of MESS is important in dealing with patients with Limbs openness damage.