AI Article Synopsis
- A systematic literature review was conducted to investigate current practices for triaging and treating mangled extremities in resource-scarce environments (RSEs).
- The review involved a structured search and evaluation by multiple researchers, resulting in 58 articles being analyzed for their level and quality of evidence.
- The findings indicated a significant lack of strong evidence in existing studies, prompting a recommendation for further consensus-driven processes to update treatment guidelines specifically for RSEs.
Article Abstract
Objective: A systematic literature review (SLR) was performed to elucidate the current triage and treatment of an entrapped or mangled extremity in resource scarce environments (RSEs).
Methods: A lead researcher followed the search strategy following inclusion and exclusion criteria. A first reviewer (FR) was randomly assigned sources. One of the 2 lead researchers was the second reviewer (SR). Each determined the level of evidence (LOE) and quality of evidence (QE) from each source. Any differing opinions between the FR and SR were discussed between them, and if differing opinions remained, then a third reviewer (the other lead researcher) discussed the article until a consensus was reached. The final opinion of each article was entered for analysis.
Results: Fifty-eight (58) articles were entered into the final study. There was 1 study determined to be LOE 1, 29 LOE 2, and 28 LOE 3, with 15 determined to achieve QE 1, 37 QE 2, and 6 QE 3.
Conclusion: This SLR showed that there is a lack of studies producing strong evidence to support the triage and treatment of the mangled extremity in RSE. Therefore, a Delphi process is suggested to adapt and modify current civilian and military triage and treatment guidelines to the RSE.
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