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Mangled Extremity Severity Score (MESS)

Johansen et al. 1990

Skeletal / soft-tissue injury
 
Low energy (stab; simple fracture; pistol gunshot wound)
1
Medium energy (open or multiple fractures, dislocation)
2
High energy (high speed RTA or rifle GSW)
3
Very high energy (high speed trauma + gross contamination)
4
Limb ischaemia
 
Pulse reduced or absent but perfusion normal
1*
Pulseless, paraesthesias, diminished capillary refill
2*
Cool, paralysed, insensate, numb
3*


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