Table I. Mangled Extremity Severity Score (MESS)
		Skeletal/soft-tissue injury
		low energy (stab ; simple fracture ; civilian gunshot wound)	1
		medium energy (open or multiple fractures, dislocation)	2
		high energy (shotgun; military gunshot wound, crush injury)	3
		very high energy (as above, plus gross contamination,	4
		soft-tissue avulsion)
		Limb ischaemia
		pulse reduced or absent but normal perfusion	1
		pulseless ; paraesthesiae ; reduced capillary refill	2
		cool, paralysed, insensate, numb	3
		(score doubled for ischaemia longer than six hours)
		Shock
		systolic BP maintained above 90 mmHg	0
		transient hypotension	1
		persistent hypotension	2
		Age (years)
		<30	0
		30 to 50	1
		>50	2