Mangled Extremity Severity Score Johansen, Hansen; J Trauma 30:568 1990
MESS Score > 7 - poor limb viability prognosis

MESS SCORE CALCULATOR
Skeletal/Soft Tissue Injury
	low energy (stab, fracture, "civilian" GSW)
	medium energy (open, multiple fxs, dislocation)
	high energy (close-range shotgun, or "military" GSW, crush injury)
	very high energy (above + gross contamination, soft tissue avulsion)
Limb Ischemia
< 6 hrs	> 6 hrs	duration of limb ischemia
		pulse reduced or absent but perfusion normal
		pulseless, parasthesias, diminished capillary refill
		cool, paralyzed, insensate, numb
Shock
	systolic BP always > 90 mm Hg
	hypotensive transiently
	persistent hypotension
Age
		< 30
		30 - 50
		> 50