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

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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

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.