Download - Salvage, NISSA Score Limb
Predictive salvage index
Artery
Supra popliteal level1
Popliteal level2
Infra popliteal level3
Bone
Mild1
Moderate2
Severe3
Muscle
Mild1
Moderate2
Severe3
Interval up to operating theatre
12 hours3
From:Indian J Orthop. 2008 OctDec; 42(4): 368376. Doi : 10.4103/0019-5413.43371. Copyright Indian Journal of Orthopaedics
Nerve injury, ischemia, soft tissue injury, skeletal injury shock & age of patient score (NISSA)
Nerve
SensateNo major nerve injury1
DorsalDeep peroneal nerve2
Plantar partialTibial nerve injury3
Plantar completeSciatic nerve4
Ischemia
NoneGood to fair pulses, no ischemia0
MildDecreased pulses perfusion1
ModerateProlonged capillary refill, Doppler pulses fill2
SeverePulseless, cool, ischemic, no doppler3
Soft Tissue
Grade IMinimal contamination0
Grade IIModerate soft tissue injury, low velocity1
Grade IIIAModerate crush injury, high velocity with Considerable contamination2
Grade IIIBMassive crush injury severe contamination3
Skeletal
Spiral or oblique fracture0
Transverse fracture-minimal contamination1
Moderate displacement and communition with high velocity2
Segmental fracture, severe communition, bony loss3
Shock
Normotensive0
Transient hypotensive1
Persistent hypotensive2
If ischemia time more than six hours, add 2 pointsFrom: Indian J Orthop. 2008 OctDec; 42(4): 368376. doi: 10.4103/0019-5413.43371. Copyright Indian Journal of OrthopaedicsLimb salvage index
Artery
Contusion, intimal tear, partial laceration0
Occlusion of two or more shank vessels, no pedal pulses felt1
Complete occlusion of femoral or three shank vessels2
Nerve
Contusions, stretch, minimal laceration0
Partial transaction or avulsion of sciatic nerve1
Complete transaction or avulsion of sciatic nerve2
Bone
Closed or open fracture with minimum communition0
Closed fracture at two or more sites at same limb;1
Open fracture with communition or moderate to large displacement with bone loss < 5 cm
Bone loss more than 5 cm Grade IIIB or IIIC2
Skin
Clean injury, primary repair, first degree burn0
Delayed closure due to contamination requiring skin graft or flap, second or third degree burn1
Musculotendinous unit
Laceration or avulsion involving the single compartment or tendon0
Complete avulsion injury involving two or more tendon1
Deep Vein
Contusion, partial laceration0
Complete laceration, avulsion or thrombosis1
Warm ischemia
Less than six hours0
6-9 hours1
9-12 hours2
12-15 hours3
More than 15 hours4
From:Indian J Orthop. 2008 OctDec; 42(4): 368376. doi: 10.4103/0019-5413.43371. Copyright Indian Journal of Orthopaedics