Principles of Open Fracture Management.

Principles of Open Fracture Management. Instr Course Lect. 2018 Feb 15;67:3-18 Authors: Patzakis MJ, Levin LS, Zalavras CG, Marcus RE Abstract Open fractures are contaminated wounds that contain gram-positive and gram-negative organisms; therefore, wide-spectrum antibiotic therapy should be incorporated into the treatment plan. Antibiotics should be initiated as soon after injury as possible, preferably within 3 hours of injury, after which time the rate of infection has been reported to increase. Time to surgical débridement within 12 hours of injury has not been reported to affect the rate of infection, given that a patient is being treated with antibiotics. An antibiotic bead pouch and vacuum-assisted wound closure may help reduce the risk for secondary and nosocomial contamination and subsequent infection. Open fractures are always associated with a soft-tissue injury; therefore, they can be considered a soft-tissue injury that involves a fracture. The management of the bone and the soft tissues in a patient with an open fracture is the major determinant of fracture healing and functional restoration of the injured extremity. The formulation of a soft-tissue treatment plan must occur during the initial wound assessment and the initial fixation of an open fracture and should not be considered a secondary or consecutive process. A soft-tissue surgeon should be consulted the night of the injury. Selection of fracture fixation depen...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research