MDCalc

Mangled Extremity Severity Score (MESS)

Estimates viability of an extremity after trauma, to determine need for salvage vs empiric amputation.

Limb ischemia for >6 hours

Limb ischemia

Patient age

Shock

Injury mechanism

Result:

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Advice
  • All patients with significant trauma require a thorough trauma assessment and resuscitation.
  • Trauma victims require management of significant craniocerebral, thoracic, abdominal, and pelvic injuries prior to consideration of limb salvage.
Management

After initial stabilization and resuscitation in the Emergency Department, urgent orthopedics consultation or transfer to a higher level of care is critical as time of ischemia plays a significant role in the MESS.

Critical Actions

Patients with a MESS ≥7 are likely to require amputation secondary to their limb trauma.