What we learn from MESS?

1. Initially was design for lower extremities, on 1980.

2. However the usage for upper limbs was validated, but the creator suggest nearly every effort should be attempt due to:

  • Upper limbs more important than lower limbs.
  • Prosthesis technology for upper limbs still primitive.

3. The treshold value of 7 (during 1980 study) need to be revise due to more advance technologies today. Probably 8 or 9.

4. This score show us that its time sensitive, since >6 hours cause multiply by 2 for limb ischemia component. So ED folks hurry up. Get the whole team STAT.

Ref:

https://www.mdcalc.com/mangled-extremity-severity-score-mess-score

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