ToolsCalculators
Mangled Extremity Severity Score (MESS)
Predicts salvageability of a severely injured limb.
Mangled Extremity Severity Score (MESS)
Skeletal / soft-tissue injury
Limb ischaemia
Points are doubled if ischaemia has lasted more than 6 hours.
Ischaemia duration >6 hours (doubles ischaemia points)
Shock
Age
Result1 point
Score <7 is associated with a salvageable limb in the original series.
- MESS total
- 1
- Ischaemia contribution
- 0
When to use
- Adjunct to the amputation-versus-salvage decision in a mangled lower extremity.
Formula
Sum of skeletal/soft-tissue injury (1-4), limb ischaemia (0-3, doubled if >6 h), shock (0-2) and age (0-2). Score >=7 predicts amputation in the original cohort.
Pearls and pitfalls
- A screening aid only; a high score should not by itself mandate amputation.
- Ischaemia points are doubled when the warm-ischaemia time exceeds 6 hours.