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The mangled extremity severity score (MESS) is a scoring system that can be applied to mangled extremities and help one determine which mangled limbs will . Mangled Extremity Severity Score (MESS). Introduction. used to predict necessity of amputation after lower extremity trauma. Variables. skeletal. fractures, soft tissue damage, vascular, nerve and tendon lesions. The Mangled Extremity Severity Score (MESS) is probably the most common scoring system.

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Trauma victims require management of significant craniocerebral, thoracic, abdominal, and pelvic injuries prior to sscore of limb salvage. Frequently, overzealous attempts at limb salvage with prolonged unsuccessful attempts at rehabilitation result in a functionally useless limb, chronic disability and pain and may be followed later by delayed amputation.

In the prospective study, out of six He is also a clinical professor of surgery at the University of Washington School of Medicine.

Cases were selected as per the following inclusion criteria:. In contrast to the original study, they excluded limbs that were amputated within 24 hours as they felt the limb-salvage score would be of little utility in these patients. Please login to add comment. A successful salvage limb was defined as an extremity that remained in the limb salvage and reconstruction pathway six months after injury.

Vascular injuries of lower limb except the foot, including dislocations of the knee, ankle, closed tibial or femoral fractures and penetrating wounds with sxtremity injury noted on color Doppler or at the time of surgery. Color Doppler of mangled extremity was carried out whenever peripheral pulses were absent and perfusion was in doubt.

In the retrospective study, all the attempted salvage patients were followed up for a period of two and a half years. The management of extremty lower extremity trauma is a subject of considerable interest and controversy.

Severe open fractures of the lower extremity: Results of the present study are consistent with the western and Indian studies [ Table 3 ]. Enter your email address and we’ll send you a link to sclre your password. An attempt to quantify the severity of the trauma and to establish numerical guidelines for the decision to amputate or salvage the limb has been proposed by many authors.


Unfortunately, while most attempts of limb salvage are successful, many are not. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mangled Extremity Severity Score (MESS)

Support Center Support Center. The Mangled Extremity Severity Score can be applied to all adult patients who present with extremity trauma, particularly lower extremity trauma.

A point system was developed to grade the severity of each of the four criteria. LSI was formulated based on the degree of injury to the arterial, nerve, bone, muscle, skin, venous and warm ischemia time.

His injuries have been graded as severe but not life-threatening injury to the chest 3 pointsmoderate injury to the abdomen 2 pointsand severe injuries but with probable survival injury to the the face or neck 4 points using the criteria for the Modified Injury Severity Score MISS.

The high sensitivity suggests that almost all limbs requiring an amputation will have MESS equal to or more than seven. Footnotes Source of Support: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score MESS in severely injured lower limbs.

Has been validated for upper extremity injuries as well.

Overview of the severely traumatized lower limb: Hodgkin’s Disease Prognosis Estimate prognosis in Hodgkin’s disease. The retrospective study group comprised 24 patients with 25 injured limbs and the prospective study group comprised 34 patients with 36 injured limbs.

Mangled Extremity Severity Score (MESS) | Calculate by QxMD

In the prospective study all the attempted salvage patients were followed up for a minimum period of six months. Advice All patients with significant trauma require a thorough trauma assessment and resuscitation. Similar results are also found by Lin et al. Numerical inputs and outputs Formula. In the prospective study of 36 injured limbs, three limbs 8.

To severitg favorites, you must log scire. Serial debridements were carried out every two to four days when required. The analysis did not validate the clinical utility of any of the scoring systems. PCI and Cardiac Surgery. Seveirty of both these studies suggest that many limbs with MESS score of equal to or more than 7 may be salvaged. Limb reconstruction versus amputation decision making in massive lower extremity trauma.


National Center for Biotechnology InformationU. Thus, enthusiasm for limb salvage techniques must be tempered by a realistic assessment of the results, not just for the injured part but for the patient as a whole. CT Severitu Index Pancreatitis Predict complication and mortality rate in pancreatitis, based on CT findings Balthazar score Expected spleen size Provides upper limit of normal for spleen length and volume by ultrasound relative to body height and gender.

More recent case series from reported two cases with MESS scores of 11 and 7, both of which were salvaged successfully. Calc Function Calcs that help predict probability of a disease Diagnosis. Study year Patients limbs Follow-up period Result Johansen et al. Expected spleen size Provides upper limit of normal for spleen length and volume by ultrasound relative to body height and gender.

Thank you for rating! Addition of the assigned points; if there has been limb ischemia for more than 6 hours, the “limb ischemia” points are doubled.

While the evolution of sophisticated microsurgical reconstruction technique has created the possibility of successful limb salvage in even the most extreme cases, it has become painfully obvious that the technical possibilities are double-edged swords.

Out of the remaining 30 injured limbs Evidence Appraisal Original study Published in based on a retrospective chart review of over lower extremity long bone fractures at Harborview Medical Center in Seattle. Please vote below and help us build the most advanced adaptive learning platform in medicine. L7 – years in practice. The clinical utility of MESS has been extensively evaluated with varying results.

In India, Sharma et al.