Amputación versus Reconstrucción de Miembro Inferior tras Lesión Traumática: Revisión Sistemática según Directrices PRISMA
DOI:
https://doi.org/10.56754/2810-6571.2024.3353Keywords:
Amputation, Surgical; Limb Salvage; Lower Extremity; Wounds and Injuries; Trauma Severity Indices; Systematic Review.Abstract
ABSTRACT.
Background: The decision between amputating or saving a traumatized limb is complex for both the medical team and the patient, especially with the emergence of new reconstructive techniques in recent years. The objective of the present study is to systematically review recently published studies that compare lower limb amputation and reconstruction after suffering traumatic injuries.
Methods: A systematic review of articles published from 2014 to 2024 was carried out in the PubMed and ScienceDirect search engines with the combination “((lower extremity) OR (lower limb)) AND (amputation AND reconstruction)”.
Results: 352 results were obtained in PubMed and 170 in ScienceDirect, of which 12 were selected to carry out the systematic review. Patients who underwent reconstruction had a better quality of life and ability to perform daily activities; however, better mental health was also associated with these results, regardless of the type of intervention. Amputee patients tended to have a significantly higher Mangled Extremity Severity Score, were older, and had arterial lesions. Being unemployed and having a medium or low level of education decreased the odds of undergoing reconstruction. Delay in reconstruction negatively affected the likelihood of limb salvage.
Discussion and Conclusion: In terms of quality of life and ability to carry out activities of daily living, good mental health had a great impact, regardless of the type of intervention, which opens the possibility of conducting new research in this regard. It was concluded that arterial lesions, age and the MESS score are variables associated with amputation. On the other hand, delay in reconstruction negatively impacts the probability of limb salvage.
KEY WORDS: Amputation, Surgical; Limb Salvage; Lower Extremity; Wounds and Injuries; Trauma Severity Indices; Systematic Review.
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References
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