Table 1. The Mangled Extremity Severity Score (MESS).

Variables	Score
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 motor vehicle accident or rifle gunshot wound)	3
Very high energy (high speed trauma + gross contamination)	4
Limb ischemia
Pulse reduced or absent but perfusion normal	1
Pulseless; paresthesias, diminished capillary refill	2*
Cool, paralyzed, insensate, numb	3*
Shock
Systolic blood pressure always >90 mmHg	0
Hypotensive transiently	1
Persistent hypotension	2
Age (years)
<30	0
30-50	1
>50	2
* Score doubled for ischemia >6 hours.