Military medicine
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The aim of this study was to examine the Mangled Extremity Severity Score (MESS) in a combat setting. ⋯ A MESS of >7 correlated with amputation, thus validating the MESS in a combat setting. A young average patient age and high-energy injury mechanism on the battlefield leave ischemic time and shock as the most important factors in dictating whether a MESS is >7 or <7.