Scholarlink

Purpose <p>To determine modifiable and non-modifiable factors contributing to limb loss in PAI the relevance and accuracy of published scoring systems for PAI within a South African State hospital.</p> Methodology <p>Retrospective review of patients (&gt; 18 years) with PAI, presenting to CMJAH trauma unit from 1 January 2017 to 31 December 2022.</p> Results <p>Sixty-four patient records were analysed. Thirty (46.9%) had blunt trauma and thirty-four (53.1%) had penetrating trauma. Gunshot wounds (GSW) were the most common mechanism of injury (MOI). Blunt PAI had a 40% amputation rate and penetrating trauma, 33.3%. Forty-seven (73.4%) had a delay to surgery of &gt; 6&#xa0;h. The mean time to arrival at our emergency department was 478&#xa0;min, and the mean time from arrival to surgery was 368&#xa0;min (total delay of 838&#xa0;min). The primary amputation rate was 28.6%, and 63.5% had successful limb salvage surgeries. The secondary amputation rate was 7.8%.</p> Conclusion <p>Compared to international literature, our rate of primary amputation is high (10% vs. 28.8%) and prolonged ischaemia is the likely cause. Only 17 (26.6%) patients presented before 6&#xa0;h. Of the 45 patients that had an attempt at revascularisation, 7.8% had a secondary amputation. Thus, despite prolonged ischaemia, revascularisation should be attempted in patients with at least two viable compartments on fasciotomy. The MESS and POPSAVEIT scoring systems should not be relied on in patients with delayed presentations. Strengthening referral triage for suspected PAI to Level 1 Trauma centres directly will decrease the delays and likely improve the outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Outcomes of popliteal artery injuries in a level 1 trauma centre: a 6-year review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月24日

查看全文
  • Kewen van Rensburg,
  • Wilme Steyn,
  • Ismail Cassimjee,
  • Maeyane Stephens Moeng

摘要

Purpose

To determine modifiable and non-modifiable factors contributing to limb loss in PAI the relevance and accuracy of published scoring systems for PAI within a South African State hospital.

Methodology

Retrospective review of patients (> 18 years) with PAI, presenting to CMJAH trauma unit from 1 January 2017 to 31 December 2022.

Results

Sixty-four patient records were analysed. Thirty (46.9%) had blunt trauma and thirty-four (53.1%) had penetrating trauma. Gunshot wounds (GSW) were the most common mechanism of injury (MOI). Blunt PAI had a 40% amputation rate and penetrating trauma, 33.3%. Forty-seven (73.4%) had a delay to surgery of > 6 h. The mean time to arrival at our emergency department was 478 min, and the mean time from arrival to surgery was 368 min (total delay of 838 min). The primary amputation rate was 28.6%, and 63.5% had successful limb salvage surgeries. The secondary amputation rate was 7.8%.

Conclusion

Compared to international literature, our rate of primary amputation is high (10% vs. 28.8%) and prolonged ischaemia is the likely cause. Only 17 (26.6%) patients presented before 6 h. Of the 45 patients that had an attempt at revascularisation, 7.8% had a secondary amputation. Thus, despite prolonged ischaemia, revascularisation should be attempted in patients with at least two viable compartments on fasciotomy. The MESS and POPSAVEIT scoring systems should not be relied on in patients with delayed presentations. Strengthening referral triage for suspected PAI to Level 1 Trauma centres directly will decrease the delays and likely improve the outcomes.