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MESS |
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MESS Mangled Extremity Severity Score. A scoring system used to evaluate the need to amputate an extremity; a MESS of 7 indicates a need to amputate
Modifying factors Loss of posterior tibial nerve causes trophic ulceration; ischemia > 6 hours doubles the MESS MESS Mangled Extremity Severity Score Traumatology A scoring system used to evaluate the need for amputation in an extremity; a MESS of ≥ 7 indicates a need to amputate Altering factors Loss of posterior tibial nerve causes trophic
ulceration, ischemia > 6 hrs doubles score. See Amputation.
MESS scoring points
Skeletal & soft tissue injury
• Low energy–stabs, simple Fx, civilian gun shot wounds
• Medium energy–open or multiple Fx, dislocation
• High-energy–close range shotgun, military gunshot wounds, crush injury
• Very high energy–as in line just above, with gross contamination or tissue avulsion
Limb ischemia
• Pulse reduced, normal perfusion
• Pulseless, paresthesia, ↓ capillary filling
• Cool, paralyzed, numb
Shock
• Systolic BP ≥ 90 mm Hg
• Transient hypotension
• Permanent hypotension
Age
• < Age 30
• Age 30–50
• > Age 50
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