Abstract:
Abstract
Introduction
In resource limited combat settings with frequent encounters of mass casualty incidents, the
decision to attempt limb salvage versus primary amputation is refined over time based on
experience. This experience can be augmented by grading systems and algorithms to assist in
clinical decisions. Few investigators have attempted to explicitly grade limb ischemia according
to clinical criteria and study the impact of limb ischemia on clinical outcome. We suggest a new
ischemia grading system based on the Rutherford ischemic classification and the V.A. Kornilov
classification which we adapted to apply to the combat setting. This new tool was then
retrospectively applied to combat trauma patients from the Sri Lankan Civil War.
Method
We retrospectively queried a prospectively maintained, single surgeon registry containing 129
extremity vascular injuries managed at a Role 3 military base hospital (MBH) from 2008
December to June 2009 during the last phase of Sri Lankan Civil war. 89 patients were analyzed
for early limb salvage according to the modified Kornilov extremity ischemia index (MKEII).
