Western Trauma Association Critical Decisions in Trauma

• DOI: 10.1097/ta.0b013e318241ed70
• Publication Date: 2016-04-18T16:09:26Z
• Authors: Thomas M. Scalea; Joseph DuBose; Ernest E. Moore; Michael West; Frederick A. Moore; Robert McIntyre; Christine Cocanour; James Davis; M. Gage Ochsner; David Feliciano
• Keywords: Expert opinion; Guideline

The operative management of mangled extremities after trauma remains controversial. We have sought to develop an evidence-based algorithm help guide practitioners when faced with these relatively infrequent but very challenging clinical dilemmas.The Western Trauma Association Critical Decisions Committee queried the literature identify high-quality managements that would care extremities. When good data were not available, relied on expert opinions, either from or our senior members.Virtually, all scoring systems used therapy been proven be valid. Hemodynamically unstable patients who failed respond initial resuscitation should taken operating room for exploration and vascular control. Those are stable undergo a stepwise neurologic evaluation process. A comprehensive factors may predict appropriateness limb salvage done in room. Patients candidates primary amputation. attempts at salvage.Patients remain significant challenge. This represents guideline based best evidence available opinion. It does establish standard care. provide framework treating physicians other healthcare professionals therapy, considering individual patients' status institutional resources.