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Table 2: Mangled Extremity Severity Score (MESS) classification. |
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|
MESS index |
Points* |
|
Soft tissue and bone injury |
|
|
Low energy (stab or small-caliber firearm injury) |
1 |
|
Moderate energy (open or multilevel fracture, moderate crushing) |
2 |
|
Alta energía (arma de fuego de corto alcance o fuego de alta velocidad) |
3 |
|
Very high energy (explosions, crushing) |
4 |
|
Shock |
|
|
Normotensive |
0 |
|
Transient hypotension (hypotensive on admission, but responsive to intravenous fluids) |
1 |
|
Prolonged hypotension (systolic blood pressure less than 90 at the scene, responds to emergency department fluids) |
2 |
|
Degree of limb ischemia |
|
|
None (pulse limb) |
0 |
|
Mild (decreased pulses/signs of ischemia) |
1 |
|
Moderate (no Doppler pulses, slow capillary filling, paresthesias and weakness) |
2 |
|
Advanced (pulseless, cold, paresis, no capillary filling) |
3 |
|
Age group |
|
|
Under 30 years of age |
0 |
|
From 30 to 49 years of age |
1 |
|
Over 50 years of age |
2 |
|
* The sum of the score is obtained: • Score greater than 6, has a predictive value of amputation close to 100%. • Score of 0-6: Probably viable limb. Taken from: Cronenwett J, Wayne K. Vascular trauma. Rutherford’s vascular surgery. 7th ed. Toronto: Elsevier; 2010. ** If the ischemic time is greater than six hours, the score doubles. |
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