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If an open fracture is suspected,… ›
Trauma⎜Open Fractures Management
Hoff, William S. MD, FACS; Bonadies, John A. MD, FACS; Cachecho, Riad MD, FACS, FCCP; Dorlac, Warren C. MD, FACS
urgent IV antibiotics, tetanus prophylaxis, and extremity stabilization and dressing.
Hoff, William S. MD, FACS; Bonadies, John A. MD, FACS; Cachecho, Riad MD, FACS, FCCP; Dorlac, Warren C. MD, FACSFrom the Division of Trauma (W.S.H.
Fractures are designated as one of three types based on wound size, soft tissue involvement, contamination, and fracture pattern. Reviewers also determined whether the respective article was relevant to the purpose of the practice management guidelines. Sorry, this question is for
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Once a fracture is identified, it is reduced as much as possible and splinted.
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(OBQ10.50)
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(OBQ12.220)
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Antibiotics are an important adjunct to the management of open fractures and should be initiated as soon as possible.
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- Todd Swenning, MD (OTFC 2019, 1.4)
3/14/2019
10/14/2017
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- Open Fractures Management
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Not all studies used an open fracture model. Initiate as soon as possible; increased infection rate when delayed for >3 hours from injury (NNT 12.5) Grade I & II Fractures Options.
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Future research should also consider the use of this modality in the acute phase of open fracture management.Open fracture with a skin wound <1 cm in length and clean.Open fracture with a laceration >1 cm in length without extensive soft tissue damage, flaps, or avulsions.Open segmental fracture with >10 cm wound with extensive soft tissue injury or a traumatic amputation (special categories in Type III include gunshot fractures and open fractures caused by farm injuries). (SBQ12FA.68)
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3/14/2019
initial treatment for all open fractures.
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Conclusion: Implementation of an evidence-based protocol for open fracture antibiotic prophylaxis resulted in significantly decreased use of aminoglycoside and glycopeptide antibiotics with no increase in skin and soft tissue infection rates.
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), Crozer Chester Medical Center, Upland, Pennsylvania; Department of Surgery (W.C.D. When the underlying fracture is associated with a cutaneous wound, prevention of wound sepsis remains the primary objective in the management of the soft tissue. Open Fractures: Unique Techniques - Sandy Schwartz, MD (OTFC 2019, 2.3)
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